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Sample records for cisplatin-based highly emetogenic

  1. Efficacy and safety of oral palonosetron compared with IV palonosetron administered with dexamethasone for the prevention of chemotherapy-induced nausea and vomiting (CINV) in patients with solid tumors receiving cisplatin-based highly emetogenic chemotherapy (HEC).

    PubMed

    Karthaus, Meinolf; Tibor, Csőszi; Lorusso, Vito; Singh-Arora, Rajender; Filippov, Alexander; Rizzi, Giada; Borroni, Maria Elisa; Rossi, Giorgia; Grunberg, Steven M

    2015-10-01

    This study aims to compare the efficacy and safety of oral palonosetron with intravenous (IV) palonosetron for the prevention of cisplatin-related chemotherapy-induced nausea and vomiting (CINV). A multinational, randomized, double-blind study enrolling adult chemotherapy-naive patients with malignant solid tumors scheduled to receive cisplatin-based highly emetogenic chemotherapy (HEC). Patients received oral palonosetron (0.50 mg) or IV palonosetron (0.25 mg), each with oral dexamethasone. The primary objective was to demonstrate non-inferiority in terms of patients with a complete response (CR, no emesis/no rescue medication) within the acute phase (0-24 h after chemotherapy administration). Of the 743 patients randomized, 739 received study medications and 738 were included in the full analysis set. The CR rate in the acute phase was high for both groups (oral 89.4 %; IV 86.2 %). As this difference in proportions (stratum-adjusted Cochran-Mantel-Haenszel method) was 3.21 % (99 % confidence interval (CI) -2.74 to 9.17 %), non-inferiority was demonstrated (since the lower limit of the 99 % CI was closer to zero than the predefined margin of 15 %). Treatment-emergent adverse events (TEAEs) related to the study drug were rare (oral 3.2 %; IV 6.5 %). No TEAEs related to study drug leading to discontinuation were reported. Non-inferiority of oral versus IV palonosetron was demonstrated. The CR rate in the acute phase was >86 % in both patient groups. The safety profiles were comparable.

  2. Rolapitant improves quality of life of patients receiving highly or moderately emetogenic chemotherapy.

    PubMed

    Chasen, Martin; Urban, Laszlo; Schnadig, Ian; Rapoport, Bernardo; Powers, Dan; Arora, Sujata; Navari, Rudolph; Schwartzberg, Lee; Gridelli, Cesare

    2017-01-01

    Addition of rolapitant to standard antiemetic therapy improved protection against chemotherapy-induced nausea and vomiting (CINV) in phase 3 trials of patients receiving highly emetogenic chemotherapy (HEC) or moderately emetogenic chemotherapy (MEC). Here, we assessed the impact of CINV on the daily lives of patients receiving HEC or MEC using the Functional Living Index-Emesis (FLIE). In three double-blind phase 3 studies, patients receiving HEC or MEC were randomized 1:1 to receive oral rolapitant 180 mg or placebo prior to chemotherapy plus 5-hydroxytryptamine type 3 receptor antagonist and dexamethasone therapy. Patients completed the FLIE questionnaire on day 6 of cycle 1. Endpoints included FLIE total score, nausea and vomiting domain scores, and the proportion of patients with no impact on daily life (total score >108 [range 18-126]). We performed a prespecified analysis of the MEC/anthracycline-cyclophosphamide (AC) study and a post hoc analysis of two pooled cisplatin-based HEC studies. In the pooled HEC studies, rolapitant significantly improved the FLIE total score (114.5 vs 109.3, p < 0.001), nausea score (55.3 vs 53.5, p < 0.05), and vomiting score (59.2 vs 55.8, p < 0.001) versus control; similar results were observed in the MEC/AC study for FLIE total score (112.7 vs 108.6, p < 0.001), nausea score (54.1 vs 52.3, p < 0.05), and vomiting score (58.6 vs 56.3, p < 0.001). A higher proportion of patients reported no impact on daily life with rolapitant than with control in the MEC/AC study (73.2 vs 67.4, p = 0.027). Compared with control, rolapitant improved quality of life in patients receiving HEC or MEC.

  3. Acupressure in Controlling Nausea in Young Patients Receiving Highly Emetogenic Chemotherapy | Division of Cancer Prevention

    Cancer.gov

    RATIONALE: Acupressure wristbands may prevent or reduce nausea and caused by chemotherapy. It is not yet known whether standard care is more effective with or without acupressure wristbands in controlling acute and delayed nausea. PURPOSE: This randomized phase III trial is studying how well acupressure wristbands work with or without standard care in controlling nausea in young patients receiving highly emetogenic chemotherapy. |

  4. Neurokinin-1 inhibitors in the prevention of nausea and vomiting from highly emetogenic chemotherapy: a network meta-analysis.

    PubMed

    Abdel-Rahman, Omar

    2016-09-01

    A network meta-analysis of the comparative effectiveness of neurokinin 1 (NK-1) inhibitors in the prophylaxis of highly emetogenic chemotherapy induced nausea and vomiting has been conducted. Eligible studies included randomized trials evaluating aprepitant, fosaprepitant, netupitant (NEPA), casopitant and rolapitant containing regimens in the setting of highly emetogenic chemotherapy. Primary outcomes of interest include complete response (CR) and rate of no significant nausea. After preclusion of ineligible studies, 19 studies were included in the final analysis. The majority of the regimens containing NK-1 inhibitors (including NEPA, aprepitant/palonosetron (palono)/dexamethasone (dexa), casopitant/granisetron (grani) or ondansetron (ondan)/dexa, aprepitant/ondan/dexa) are better than regimens not containing them (palono/dexa, ondan/dexa, grani/dexa) in terms of achieving a CR in the overall phase. Moreover, casopitant/grani or ondan/dexa and aprepitant/grani or ondan/dexa are better than rolapitant/ondan or grani/dexa in terms of CR achievement [odds ratio (OR) 1.62, 95% credible interval (CrI) 1.14-2.23, and OR 1.28, 95% CrI 1.01-1.59, respectively]. Taking into consideration the limitations of cross-trial comparisons, regimens containing neurokinin inhibitors are associated with higher CR rates than regimens not containing them. Moreover, casopitant and aprepitant regimens seem to be more effective than rolapitant regimens.

  5. Antiemetic Therapy With or Without Olanzapine in Preventing Chemotherapy-Induced Nausea and Vomiting in Patients With Cancer Receiving Highly Emetogenic Chemotherapy | Division of Cancer Prevention

    Cancer.gov

    This randomized phase III trial studies antiemetic therapy with olanzapine to see how well they work compared to antiemetic therapy alone in preventing chemotherapy-induced nausea and vomiting in patients with cancer receiving highly emetogenic (causes vomiting) chemotherapy. Antiemetic drugs, such as palonosetron hydrochloride, ondansetron, and granisetron hydrochloride, may help lessen or prevent nausea and vomiting in patients treated with chemotherapy. |

  6. Pharmacokinetics, safety, and efficacy of APF530 (extended-release granisetron) in patients receiving moderately or highly emetogenic chemotherapy: results of two Phase II trials.

    PubMed

    Gabrail, Nashat; Yanagihara, Ronald; Spaczyński, Marek; Cooper, William; O'Boyle, Erin; Smith, Carrie; Boccia, Ralph

    2015-01-01

    Despite advances with new therapies, a significant proportion of patients (>30%) suffer delayed-onset chemotherapy-induced nausea and vomiting (CINV) despite use of antiemetics. APF530 is a sustained-release subcutaneous (SC) formulation of granisetron for preventing CINV. APF530 pharmacokinetics, safety, and efficacy were studied in two open-label, single-dose Phase II trials (C2005-01 and C2007-01, respectively) in patients receiving moderately emetogenic chemotherapy or highly emetogenic chemotherapy. In C2005-01, 45 patients received APF530 250, 500, or 750 mg SC (granisetron 5, 10, or 15 mg, respectively). In C2007-01, 35 patients were randomized to APF530 250 or 500 mg SC. Injections were given 30 to 60 minutes before single-day moderately emetogenic chemotherapy or highly emetogenic chemotherapy. Plasma granisetron was measured from predose to 168 hours after study drug administration. Safety and efficacy were also evaluated. APF530 pharmacokinetics were dose proportional, with slow absorption and elimination of granisetron after a single SC dose. Median time to maximum plasma concentration and half-life were similar for APF530 250 and 500 mg in both trials, with no differences between the groups receiving moderately and highly emetogenic chemotherapy. Exposure to granisetron was maintained at a therapeutic level over the delayed-onset phase, at least 168 hours. Adverse events in both trials were as expected for granisetron; injection site reactions (eg, erythema and induration) were predominantly mild and seen in ≤20% of patients. Complete responses (no emesis, with no rescue medication) were obtained in the acute, delayed, and overall phases in ≥80% and ≥75% of patients in both trials with the 250 and 500 mg doses, respectively. After a single injection of APF530, there were dose-proportional pharmacokinetics and sustained concentrations of granisetron over 168 hours. The 250 and 500 mg doses were well tolerated and maintained therapeutic granisetron

  7. Defining the efficacy of neurokinin-1 receptor antagonists in controlling chemotherapy-induced nausea and vomiting in different emetogenic settings-a meta-analysis.

    PubMed

    Jordan, Karin; Warr, David G; Hinke, Axel; Sun, Linda; Hesketh, Paul J

    2016-05-01

    This meta-analysis was performed to evaluate the efficacy of neurokinin-1 receptor antagonists (NK1RAs) for the prevention of chemotherapy-induced nausea and vomiting (CINV) across different categories of chemotherapeutic emetogenicity. A systematic review of MEDLINE (via PubMed) and OVID databases, plus major oncology conferences, identified randomized, controlled trials evaluating NK1RAs in combination with a 5-HT3 RA plus a glucocorticoid for management of CINV. Efficacy end points were no emesis, no nausea, and complete response (CR) rates. Data were analyzed using a random effects model. Twenty-three trials (N = 11,814) were identified. Based on absolute differences (AD) for no emesis (21 %), no nausea (8 %), CR (16 %), and odd ratios (OR) of 2.62, 1.43, and 2.16, respectively, NK1RA regimens provided better CINV protection versus control groups (all p < 0.00001) in patients receiving cisplatin-based highly emetogenic chemotherapy (HEC). In patients receiving anthracycline/cyclophosphamide (AC)-based HEC, respective ADs and ORs were 14, 4, and 11 % and 1.97 (p < 0.0001), 1.17 (p = 0.04), and 1.62 (p < 0.00001). In patients receiving moderately emetogenic chemotherapy (3 trials), no statistically significant benefit of NK1RAs was found; however, positive trends were detected for CR and no emesis. NK1RAs were effective for CINV prevention in a small number of studies using high-dose chemotherapy as conditioning prior to stem cell transplant and cisplatin-based multiple-day chemotherapy (MDC). This meta-analysis demonstrated the efficacy of NK1RA in preventing vomiting in patients receiving HEC (including AC), with smaller effects on prevention of nausea. Efficacy is also seen with high-dose chemotherapy and cisplatin-based MDC.

  8. Personalized Estimate of Chemotherapy-Induced Nausea and Vomiting: Development and External Validation of a Nomogram in Cancer Patients Receiving Highly/Moderately Emetogenic Chemotherapy

    PubMed Central

    Hu, Zhihuang; Liang, Wenhua; Yang, Yunpeng; Keefe, Dorothy; Ma, Yuxiang; Zhao, Yuanyuan; Xue, Cong; Huang, Yan; Zhao, Hongyun; Chen, Likun; Chan, Alexandre; Zhang, Li

    2016-01-01

    Abstract Chemotherapy-induced nausea and vomiting (CINV) is presented in over 30% of cancer patients receiving highly/moderately emetogenic chemotherapy (HEC/MEC). The currently recommended antiemetic therapy is merely based on the emetogenic level of chemotherapy, regardless of patient's individual risk factors. It is, therefore, critical to develop an approach for personalized management of CINV in the era of precision medicine. A number of variables were involved in the development of CINV. In the present study, we pooled the data from 2 multi-institutional investigations of CINV due to HEC/MEC treatment in Asian countries. Demographic and clinical variables of 881 patients were prospectively collected as defined previously, and 862 of them had full documentation of variables of interest. The data of 548 patients from Chinese institutions were used to identify variables associated with CINV using multivariate logistic regression model, and then construct a personalized prediction model of nomogram; while the remaining 314 patients out of China (Singapore, South Korea, and Taiwan) entered the external validation set. C-index was used to measure the discrimination ability of the model. The predictors in the final model included sex, age, alcohol consumption, history of vomiting pregnancy, history of motion sickness, body surface area, emetogenicity of chemotherapy, and antiemetic regimens. The C-index was 0.67 (95% CI, 0.62–0.72) for the training set and 0.65 (95% CI, 0.58–0.72) for the validation set. The C-index was higher than that of any single predictor, including the emetogenic level of chemotherapy according to current antiemetic guidelines. Calibration curves showed good agreement between prediction and actual occurrence of CINV. This easy-to-use prediction model was based on chemotherapeutic regimens as well as patient's individual risk factors. The prediction accuracy of CINV occurrence in this nomogram was well validated by an independent data set

  9. Management of chemotherapy-induced nausea and vomiting in patients receiving multiple-day highly or moderately emetogenic chemotherapy: role of transdermal granisetron.

    PubMed

    Coluzzi, Flaminia; Mattia, Consalvo

    2016-08-01

    Granisetron transdermal delivery system (GTDS) is the first 5-HT3 drug to be transdermally delivered and represents a convenient alternative to oral and intravenous antiemetics for the treatment of chemotherapy-induced nausea and vomiting. GTDS is effective and well tolerated in patients receiving multiple-day moderate-to-highly emetogenic chemotherapy. In this setting noninferiority studies showed similar efficacy when GTDS was compared with intravenous and oral granisetron and intravenous palonosetron. GTDS has shown good cardiovascular safety; however, special caution is needed in patients at risk for developing excessive QTc interval prolongation and arrhythmias. So far, GTDS has been investigated for intravenous prevention in comparison with granisetron and palonosetron; however, further prospects open the route to future clinical investigations.

  10. The use of olanzapine versus metoclopramide for the treatment of breakthrough chemotherapy-induced nausea and vomiting in patients receiving highly emetogenic chemotherapy.

    PubMed

    Navari, Rudolph M; Nagy, Cindy K; Gray, Sarah E

    2013-06-01

    Olanzapine has been shown to be a safe and effective agent for the prevention of chemotherapy-induced nausea and vomiting (CINV). Olanzapine may also be an effective rescue medication for patients who develop breakthrough CINV despite having received guideline-directed CINV prophylaxis. A double-blind, randomized phase III trial was performed for the treatment of breakthrough CINV in chemotherapy-naive patients receiving highly emetogenic chemotherapy (cisplatin, ≥ 70 mg/m2 or doxorubicin, ≥ 50 mg/m2 and cyclophosphamide, ≥ 600 mg/m2), comparing olanzapine to metoclopramide. Patients who developed breakthrough emesis or nausea despite prophylactic dexamethasone (12 mg IV), palonosetron (0.25 mg IV), and fosaprepitant (150 mg IV) pre-chemotherapy and dexamethasone (8 mg p.o. daily, days 2-4) post-chemotherapy were randomized to receive olanzapine, 10 mg orally daily for 3 days or metoclopramide, 10 mg orally TID for 3 days. Patients were monitored for emesis and nausea for 72 h after taking olanzapine or metoclopramide. Two hundred seventy-six patients (median age 62 years, range 38-79; 43% women; Eastern Cooperative Oncology Group (ECOG) PS 0,1) consented to the protocol. One hundred twelve patients developed breakthrough CINV and 108 were evaluable. During the 72-h observation period, 39 out of 56 (70%) patients receiving olanzapine had no emesis compared to 16 out of 52 (31%) patients with no emesis for patients receiving metoclopramide (p < 0.01). Patients without nausea (0, scale 0-10, M.D. Anderson Symptom Inventory) during the 72-h observation period were those who took olanzapine, 68% (38 of 56), and metoclopramide, 23% (12 of 52) (p < 0.01). There were no grade 3 or 4 toxicities. Olanzapine was significantly better than metoclopramide in the control of breakthrough emesis and nausea in patients receiving highly emetogenic chemotherapy.

  11. The efficacy of irinotecan, paclitaxel, and oxaliplatin (IPO) in relapsed germ cell tumours with high-dose chemotherapy as consolidation: a non-cisplatin-based induction approach.

    PubMed

    Badreldin, Waleed; Krell, Jonathan; Chowdhury, Simon; Harland, Stephen J; Mazhar, Danish; Harding, Victoria; Frampton, Adam E; Wilson, Peter; Berney, Daniel; Stebbing, Justin; Shamash, Jonathan

    2016-03-01

    To determine the outcome of an expanded cohort of patients with relapsed germ cell tumours (GCTs) treated with a salvage chemotherapy regimen consisting of irinotecan, paclitaxel and oxaliplatin (IPO) and assess the role of IPO as an alternative to standard cisplatin-based chemotherapy regimens in this setting. The results of 72 consecutive patients were reviewed retrospectively. IPO was used either as a second-line treatment (29 patients), of which 20 patients subsequently received high-dose chemotherapy (HDCT), or third-line (43), of which 32 patients proceeded to HDCT. The 2-year progression-free survival (PFS) and 3-year overall survival (OS) rates for the whole cohort were 30.2% (95% confidence interval [CI] 17.3-40.5%) and 33.4% (95% CI 20.1-43.8%), respectively. Complete remission was achieved in 3%, marker-negative partial response (PR) in 41%, marker-positive PR in 18%, stable disease in 17% and progressive disease in 20%. In the second-line setting, the 2-year PFS rate was 43.5% (95% CI 21.7-60.8%) and 3-year OS 49.1% (95% CI 24.2-65.1%). In the third-line setting, the 2-year PFS rate was 21.0% (95% CI 9.5-35.4%) and the 3-year OS rate was 23.9% (95% CI 11.7-38.2). According to the current international prognostic factor study group criteria for first relapse for the high- and very high-risk group the 2-year PFS rates were 50% and 30%, respectively. There were two treatment-related deaths from IPO, and four from HDCT. Grade 3 or 4 toxicities included neutropenia (35%), thrombocytopaenia (18%), infection (15%), diarrhoea (11%) and lethargy (8%). IPO offers an effective, well-tolerated, non-nephrotoxic alternative to cisplatin-based salvage regimens for patients with relapsed GCTs. It appears particularly useful in high-risk patients and for those in whom cisplatin is ineffective or contra-indicated. © 2015 The Authors BJU International © 2015 BJU International Published by John Wiley & Sons Ltd.

  12. 2016 Updated MASCC/ESMO consensus recommendations: Emetic risk classification and evaluation of the emetogenicity of antineoplastic agents.

    PubMed

    Jordan, Karin; Chan, Alexandre; Gralla, Richard J; Jahn, Franziska; Rapoport, Bernardo; Warr, David; Hesketh, Paul J

    2017-01-01

    Employing the same framework as in previous guideline updates, antineoplastic agents were classified into four emetic risk categories. The classification of the emetogenic level of new antineoplastic agents, especially for the oral drugs, represents an increasing challenge. Accurate reporting of emetogenicity of new antineoplastic agents in the absence of preventive antiemetic treatment is rarely available. A systematic search was conducted for drugs approved after 2009 until June 2015 using EMBASE and PubMed. The search term was "drug name." The restrictions were language (English records only), date (2009 to 2015), and level of evidence ("clinical trial"). From January 2009 to June 2015, 42 new antineoplastic agents were identified and a systematic search was conducted to identify relevant studies to help define emetic risk levels. The reported incidence of vomiting varied across studies for many agents, but there was adequate evidence to allow 41 of the 42 new antineoplastic agents to be classified according to emetogenic risk. No highly emetogenic agents were identified. Seven moderately emetogenic agents, 26 low emetogenic, agents and eight minimal emetogenic agents were identified and classified accordingly. The MASCC/ESMO update committee also recommended reclassification of the combination of an anthracycline and cyclophosphamide (AC) as highly emetogenic. Despite several limitations, we have attempted to provide a reasonable approximation of the emetic risk associated with new antineoplastic agents through a comprehensive search of the available literature. Hopefully by the next update, more precise information on emetic risk will have been collected during new agent development process.

  13. Randomized phase III trial of APF530 versus palonosetron in the prevention of chemotherapy-induced nausea and vomiting in a subset of patients with breast cancer receiving moderately or highly emetogenic chemotherapy.

    PubMed

    Boccia, Ralph; O'Boyle, Erin; Cooper, William

    2016-02-26

    APF530 provides controlled, sustained-release granisetron for preventing acute (0-24 h) and delayed (24-120 h) chemotherapy-induced nausea and vomiting (CINV). In a phase III trial, APF530 was noninferior to palonosetron in preventing acute CINV following single-dose moderately (MEC) or highly emetogenic chemotherapy (HEC) and delayed CINV in MEC (MEC and HEC defined by Hesketh criteria). This exploratory subanalysis was conducted in the breast cancer subpopulation. Patients were randomized to subcutaneous APF530 250 or 500 mg (granisetron 5 or 10 mg) or intravenous palonosetron 0.25 mg during cycle 1. Palonosetron patients were randomized to APF530 for cycles 2 to 4. The primary efficacy end point was complete response (CR, no emesis or rescue medication) in cycle 1. Among breast cancer patients (n = 423 MEC, n = 185 HEC), > 70 % received anthracycline-containing regimens in each emetogenicity subgroup. There were no significant between-group differences in CRs in cycle 1 for acute (APF530 250 mg: MEC 71 %, HEC 77 %; 500 mg: MEC 73 %, HEC 73 %; palonosetron: MEC 68 %, HEC 66 %) and delayed (APF530 250 mg: MEC 46 %, HEC 58 %; 500 mg: MEC 48 %, HEC 63 %; palonosetron: MEC 52 %, HEC 52 %) CINV. There were no significant differences in within-cycle CRs between APF530 doses for acute and delayed CINV in MEC or HEC in cycles 2 to 4; CRs trended higher in later cycles, with no notable differences in adverse events between breast cancer and overall populations. APF530 effectively prevented acute and delayed CINV over 4 chemotherapy cycles in breast cancer patients receiving MEC or HEC. Clinicaltrials.gov identifier: NCT00343460 (June 22, 2006).

  14. Evaluation of new antiemetic agents and definition of antineoplastic agent emetogenicity--state of the art.

    PubMed

    Grunberg, Steven M; Warr, David; Gralla, Richard J; Rapoport, Bernardo L; Hesketh, Paul J; Jordan, Karin; Espersen, Birgitte T

    2011-03-01

    Antiemetic drug development can follow the same logical path as antineoplastic drug development from appropriate preclinical models through Phase I, Phase II, and Phase III testing. However, due to the marked success of antiemetic therapy over the last 25 years, placebo antiemetic treatment against highly or moderately emetogenic chemotherapy is not acceptable. Promising antiemetic agents therefore rapidly reach Phase III testing, where they are substituted into or added to effective and accepted regimens. One challenge of antiemetic drug development is determining whether substitution is indeed acceptable or whether prior regimens must be maintained intact as a basis for further antiemetic drug development. An additional challenge is the classification of emetogenic level of new antineoplastic agents. Accurate reporting of emetogenicity of such antineoplastic agents in the absence of preventive antiemetic treatment may not be available. However, at the 2009 Multinational Association of Supportive Care in Cancer (MASCC)/European Society of Medical Oncology (ESMO) Consensus Conference, an expert panel used best available data to establish rankings of emetogenicity. Oral chemotherapeutic agents are ranked separately from intravenous agents, recognizing intrinsic differences in emetogenicity as well as differing schedules of administration. Since oral chemotherapeutic agents are often administered in extended regimens, the distinction between acute and delayed emesis is less clear, and cumulative emesis must be considered. As control of vomiting has improved, attention has shifted to control of nausea, a related but distinct and equally important problem. Additional efforts will be necessary to understand mechanisms of nausea and to identify optimal remedies.

  15. Predictive Factors for Developing Venous Thrombosis during Cisplatin-Based Chemotherapy in Testicular Cancer.

    PubMed

    Heidegger, Isabel; Porres, Daniel; Veek, Nica; Heidenreich, Axel; Pfister, David

    2017-01-01

    Malignancies and cisplatin-based chemotherapy are both known to correlate with a high risk of venous thrombotic events (VTT). In testicular cancer, the information regarding the incidence and reason of VTT in patients undergoing cisplatin-based chemotherapy is still discussed controversially. Moreover, no risk factors for developing a VTT during cisplatin-based chemotherapy have been elucidated so far. We retrospectively analyzed 153 patients with testicular cancer undergoing cisplatin-based chemotherapy at our institution for the development of a VTT during or after chemotherapy. Clinical and pathological parameters for identifying possible risk factors for VTT were analyzed. The Khorana risk score was used to calculate the risk of VTT. Student t test was applied for calculating the statistical significance of differences between the treatment groups. Twenty-six out of 153 patients (17%) developed a VTT during chemotherapy. When we analyzed the risk factors for developing a VTT, we found that Lugano stage ≥IIc was significantly (p = 0.0006) correlated with the risk of developing a VTT during chemotherapy. On calculating the VTT risk using the Khorana risk score model, we found that only 2 out of 26 patients (7.7%) were in the high-risk Khorana group (≥3). Patients with testicular cancer with a high tumor volume have a significant risk of developing a VTT with cisplatin-based chemotherapy. The Khorana risk score is not an accurate tool for predicting VTT in testicular cancer. © 2017 S. Karger AG, Basel.

  16. Phase III Double-Blind, Placebo-Controlled Study of Gabapentin for the Prevention of Delayed Chemotherapy-Induced Nausea and Vomiting in Patients Receiving Highly Emetogenic Chemotherapy, NCCTG N08C3 (Alliance)

    PubMed Central

    Barton, Debra L.; Thanarajasingam, Gita; Sloan, Jeff A.; Diekmann, Brent; Fuloria, Jyotsna; Kottschade, Lisa A.; Lyss, Alan P.; Jaslowski, Anthony J.; Mazurczak, Miroslaw A.; Blair, Scott C.; Terstriep, Shelby; Loprinzi, Charles L.

    2014-01-01

    BACKGROUND Despite targeted antiemetics, data support an unmet need related to the management of delayed nausea and vomiting (NV). Promising pilot data informed this phase III trial evaluating gabapentin for delayed NV from highly emetogenic chemotherapy (HEC). METHODS Participants were randomized to receive prophylactic treatment with 20 mg of dexamethasone and a 5HT3 receptor antagonist (RA) on the day of chemotherapy, followed by gabapentin 300 mg twice a day and dexamethasone (dex) or placebo and dex after HEC. Gabapentin/placebo was started the day of chemotherapy and continued through day 5 for the first chemotherapy cycle, whereas dex was titrated down on days 2–4. The primary end point was complete response (CR), defined as no emesis and no use of rescue medications on days 2–6, using an NV diary. The percentages of those in each group with a CR were compared by Fisher’s exact test. RESULTS Four hundred thirty patients were enrolled in this study. Forty-seven percent of patients in the gabapentin arm and 41% in the placebo arm had a CR (P = .23). Mean number of emesis episodes was <0.5 daily, and mean nausea severity was <2 (mild). In both arms, patient satisfaction with NV control was greater than 8 (with 10 being perfectly satisfied). There were no significant differences in unwanted side effects. CONCLUSIONS In this study, gabapentin did not significantly improve delayed NV. Patients were satisfied with the control of their nausea and vomiting irrespective of arm. The use of a 5HT3 RA and dexamethasone provided good control of nausea and vomiting for most patients. PMID:25043153

  17. Efficacy of palonosetron (PAL) compared to other serotonin inhibitors (5-HT3R) in preventing chemotherapy-induced nausea and vomiting (CINV) in patients receiving moderately or highly emetogenic (MoHE) treatment: systematic review and meta-analysis.

    PubMed

    Botrel, Tobias Engel Ayer; Clark, Otávio Augusto C; Clark, Luciana; Paladini, Luciano; Faleiros, Enéas; Pegoretti, Bruna

    2011-06-01

    The objective of this work is to perform a systematic review and meta-analysis of all randomized controlled trials comparing a single intravenous dose of palonosetron (PAL) 0.25 mg with other 5-HT(3)R in patients receiving moderately or highly emetogenic (MoHE) chemotherapy. Several databases were searched, including MEDLINE, EMBASE, LILACS, and CENTRAL. The primary endpoints were the incidence of acute and delayed nausea and vomiting. The side effects of each treatment were analyzed. A subgroup analysis was performed to evaluate the influence of the use of corticosteroids. The results are expressed as risk ratio (RR) and the correspondent 95% confidence interval (CI). Five studies were included, with 2057 patients. PAL was compared with ondansetron, granisetron, and dolasetron. Patients in PAL group had less nausea, both acute (RR = 0.86; CI 95% = 0.76 to 0.96; p = 0.007) and delayed (RR = 0.82; CI95% = 0.75 to 0.89; p < 0.00001). They also had less acute vomiting (RR = 0.76; CI 95% = 0.66 to 0.88; p = 0.0002) and delayed vomiting (RR = 0.76; CI95% = 0.68 to 0.85; p < 0.00001). There were no statistical differences in side effects like headache (RR = 0.84; CI 95% = 0.61 to 1.17; p = 0.30), dizziness (RR = 0.40; CI 95% = 0.13 to 1.27; p = 0.12), constipation (RR = 1.29; CI 95% = 0.77 to 2.17; p = 0.33) or diarrhea (RR = 0.67; CI 95% = 0.24 to 1.85; p = 0.44). Patients receiving PAL presented less nausea and vomiting regardless of the use of corticoids. We found no statistical heterogeneity in the global analysis. PAL was more effective than the other 5-HT(3)R in preventing acute and delayed CINV in patients receiving MoHE treatments, regardless of the use of concomitant corticosteroids.

  18. Sustained antiemetic responses with APF530 (sustained-release granisetron) during multiple cycles of emetogenic chemotherapy.

    PubMed

    Boccia, Ralph; Cooper, William; O'Boyle, Erin

    2015-02-01

    A phase 3 trial in patients with cancer who received chemotherapy has shown that subcutaneous (SC) APF530, a sustained-delivery formulation of granisetron, is noninferior to palonosetron in preventing acute (0-24 hours) and delayed (>24-120 hours) chemotherapy-induced nausea and vomiting (CINV). To investigate the sustainability of APF530 antiemetic responses during multiple chemotherapy cycles. 1,395 patients receiving moderately or highly emetogenic chemotherapy (MEC and HEC, respectively) were randomized either to APF530 250 or 500 mg SC (containing granisetron 5 or 10 mg, respectively) or palonosetron 0.25 mg intravenously before cycle 1 of chemotherapy. Patients who received palonosetron in cycle 1 were rerandomized in cycles 2-4 to APF530 250 or 500 mg; those who received APF530 in cycle 1 continued their APF530 dose. Between-group response rates were compared using the Fisher exact test. Complete response (CR; no emesis, no rescue medication) for APF530 500 mg with HEC increased from 81.3% to 87.8% over 4 cycles in the acute phase of CINV, and from 67.1% to 83.1% in the delayed phase. Rates were slightly lower with MEC. Within-cycle CR rates between APF530 doses showed no significant differences. With HEC, APF530 500 mg provided sustained CRs through 4 cycles of chemotherapy in 68.4% of patients in the acute phase and in 57.9% in the delayed phase; with MEC, corresponding CRs were 56.5% and 41.3%. Nausea prevention was nearly as effective as emesis prevention. Chemotherapy emetogenicity was classified according to Hesketh criteria during the time of this study. However, subsequent post hoc analyses indicate that reclassification according to newer ASCO emetogenicity guidelines did not alter the original study noninferiority conclusions. CR rates with APF530 during the acute and delayed phases of CINV in MEC and HEC were maintained over multiple cycles. ©2015 Frontline Medical Communications.

  19. Predicting and preventing thromboembolic events in patients receiving cisplatin-based chemotherapy for germ cell tumours.

    PubMed

    Gizzi, Marco; Oberic, Lucie; Massard, Christophe; Poterie, Audrey; Gwenael, Le Teuff; Loriot, Yohann; Albiges, Laurence; Baciarello, Giulia; Michels, Judith; Bossi, Alberto; Blanchard, Pierre; Escudier, Bernard; Fizazi, Karim

    2016-12-01

    Patients with germ cell tumours (GCT) receiving cisplatin-based chemotherapy are at high risk of thromboembolic events (TEE). Previously, we identified serum lactate dehydrogenase (LDH) and body surface area (BSA) as independent predictive factors for TEE. The aim of this study was to validate these predictive factors and to assess the impact of thromboembolism prophylaxis in patients at risk of deep venous thrombosis (DVT). Between 2001 and 2014, 295 patients received first-line cisplatin-based chemotherapy for GCT. Preventive anticoagulation with low-molecular-weight heparin (LMWH) was progressively implemented in patients with predictive factors. Sixteen patients with evidence of TEE before starting chemotherapy were excluded from the analysis. Among 279 eligible patients, a TEE occurred in 38 (14%) consisting of DVT (n = 26), arterial thrombosis (n = 2), and superficial thrombophlebitis (n = 10). DVT occurred in 26 (12.7%) of 204 patients with risk factors versus two (2.6%) of 75 patients with no risk factors (p = 0.01). After a prevention protocol was progressively implemented from 2005, primary thromboprophylaxis was administered to 104 patients (68%) with risk factors. Among patients at risk (n = 151), the incidence of DVT decreased by roughly half when they received a LMWH: 9/97 (9.2%) and 9/54 (16.6%), respectively (p = 0.23). Patients with GCT who receive cisplatin-based chemotherapy are at risk of developing a TEE which can be predicted by elevated serum LDH. To our knowledge this is the first study exploring LMWH as thromboprophylaxis in GCT patients. A prospective trial testing prophylactic anticoagulation is warranted. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. SERPINB1 expression is predictive for sensitivity and outcome of cisplatin-based chemotherapy in melanoma

    PubMed Central

    Willmes, Christoph; Kumar, Rajiv; Becker, Jürgen C.; Fried, Isabella; Rachakonda, P. Sivaramakrishna; Poppe, Lidia M.; Hesbacher, Sonja; Schadendorf, Dirk; Sucker, Antje

    2016-01-01

    Despite of highly effective new therapeutic strategies, chemotherapy still is an important treatment option in metastatic melanoma. Since predictors of chemotherapy response are rare, drugs and regimens are currently chosen arbitrarily. The present study was aimed at the identification of molecular markers predicting the outcome of chemotherapy in melanoma. Tumor biopsies from metastatic lesions were collected from 203 stage IV melanoma patients prior to chemotherapy onset and used for gene expression profiling (n = 6; marker identification set), quantitative real-time PCR (n = 127; validation set 1), and immunohistochemistry on tissue microarrays (n = 70; validation set 2). The results were correlated to the tumors' in-vitro chemosensitivity and to the patients' in-vivo chemotherapy outcome. SERPINB1 was found to correlate to the in-vitro sensitivity to cisplatin-containing chemotherapy regimens (p = 0.005). High SERPINB1 gene expression was associated with favorable tumor response (p = 0.012) and prolonged survival (p = 0.081) under cisplatin-based chemotherapy. High SERPINB1 protein expression in tumor tissue from cisplatin-treated patients was associated with a favorable survival (p = 0.011), and proved as an independent predictor of survival (p = 0.008) by multivariate analysis. We conclude, that SERPINB1 expression, although not functionally involved, is predictive for the outcome of cisplatin-based chemotherapy in melanoma, and thus may be useful to personalize melanoma chemotherapy. PMID:26799424

  1. SERPINB1 expression is predictive for sensitivity and outcome of cisplatin-based chemotherapy in melanoma.

    PubMed

    Willmes, Christoph; Kumar, Rajiv; Becker, Jürgen C; Fried, Isabella; Rachakonda, P Sivaramakrishna; Poppe, Lidia M; Hesbacher, Sonja; Schadendorf, Dirk; Sucker, Antje; Schrama, David; Ugurel, Selma

    2016-03-01

    Despite of highly effective new therapeutic strategies, chemotherapy still is an important treatment option in metastatic melanoma. Since predictors of chemotherapy response are rare, drugs and regimens are currently chosen arbitrarily. The present study was aimed at the identification of molecular markers predicting the outcome of chemotherapy in melanoma. Tumor biopsies from metastatic lesions were collected from 203 stage IV melanoma patients prior to chemotherapy onset and used for gene expression profiling (n = 6; marker identification set), quantitative real-time PCR (n = 127; validation set 1), and immunohistochemistry on tissue microarrays (n = 70; validation set 2). The results were correlated to the tumors' in-vitro chemosensitivity and to the patients' in-vivo chemotherapy outcome. SERPINB1 was found to correlate to the in-vitro sensitivity to cisplatin-containing chemotherapy regimens (p = 0.005). High SERPINB1 gene expression was associated with favorable tumor response (p = 0.012) and prolonged survival (p = 0.081) under cisplatin-based chemotherapy. High SERPINB1 protein expression in tumor tissue from cisplatin-treated patients was associated with a favorable survival (p = 0.011), and proved as an independent predictor of survival (p = 0.008) by multivariate analysis. We conclude, that SERPINB1 expression, although not functionally involved, is predictive for the outcome of cisplatin-based chemotherapy in melanoma, and thus may be useful to personalize melanoma chemotherapy.

  2. Efficacy of triplet regimen antiemetic therapy for chemotherapy-induced nausea and vomiting (CINV) in bone and soft tissue sarcoma patients receiving highly emetogenic chemotherapy, and an efficacy comparison of single-shot palonosetron and consecutive-day granisetron for CINV in a randomized, single-blinded crossover study.

    PubMed

    Kimura, Hiroaki; Yamamoto, Norio; Shirai, Toshiharu; Nishida, Hideji; Hayashi, Katsuhiro; Tanzawa, Yoshikazu; Takeuchi, Akihiko; Igarashi, Kentaro; Inatani, Hiroyuki; Shimozaki, Shingo; Kato, Takashi; Aoki, Yu; Higuchi, Takashi; Tsuchiya, Hiroyuki

    2015-03-01

    The first aim of this study was to evaluate combination antiemetic therapy consisting of 5-HT3 receptor antagonists, neurokinin-1 receptor antagonists (NK-1RAs), and dexamethasone for multiple high emetogenic risk (HER) anticancer agents in bone and soft tissue sarcoma. The second aim was to compare the effectiveness of single-shot palonosetron and consecutive-day granisetron in a randomized, single-blinded crossover study. A single randomization method was used to assign eligible patients to the palonosetron or granisetron arm. Patients in the palonosetron arm received a palonosetron regimen during the first and third chemotherapy courses and a granisetron regimen during the second and fourth courses. All patients received NK-1RA and dexamethasone. Patients receiving the palonosetron regimen were administered 0.75 mg palonosetron on day 1, and patients receiving the granisetron regimen were administered 3 mg granisetron twice daily on days 1 through 5. All 24 patients in this study received at least 4 chemotherapy courses. A total of 96 courses of antiemetic therapy were evaluated. Overall, the complete response CR rate (no emetic episodes and no rescue medication use) was 34%, while the total control rate (a CR plus no nausea) was 7%. No significant differences were observed between single-shot palonosetron and consecutive-day granisetron. Antiemetic therapy with a 3-drug combination was not sufficient to control chemotherapy-induced nausea and vomiting (CINV) during chemotherapy with multiple HER agents for bone and soft tissue sarcoma. This study also demonstrated that consecutive-day granisetron was not inferior to single-shot palonosetron for treating CINV.

  3. Ototoxicity After Intensity-Modulated Radiation Therapy and Cisplatin-Based Chemotherapy in Children With Medulloblastoma

    SciTech Connect

    Paulino, Arnold C.; Lobo, Mark; Teh, Bin S.; Okcu, M. Fatih; South, Michael; Butler, E. Brian; Su, Jack; Chintagumpala, Murali

    2010-12-01

    Purpose: To report the incidence of Pediatric Oncology Group (POG) Grade 3 or 4 ototoxicity in a cohort of patients treated with craniospinal irradiation (CSI) followed by posterior fossa (PF) and/or tumor bed (TB) boost using intensity-modulated radiation therapy (IMRT). Methods and Materials: From 1998 to 2006, 44 patients with medulloblastoma were treated with CSI followed by IMRT to the PF and/or TB and cisplatin-based chemotherapy. Patients with standard-risk disease were treated with 18 to 23.4 Gy CSI followed by either a (1) PF boost to 36 Gy and TB boost to 54 to 55.8 Gy or (2) TB boost to 55.8 Gy. Patients with high-risk disease received 36 to 39.6 Gy CSI followed by a (1) PF boost to 54 to 55.8 Gy, (2) PF boost to 45 Gy and TB boost to 55.8 Gy, or (3) TB boost to 55.8 Gy. Median audiogram follow-up was 41 months (range, 11-92.4 months). Results: POG Grade Ototoxicity 0, 1, 2, 3. and 4 was found in 29, 32, 11, 13. and 3 ears. respectively, with POG Grade 3 or 4 accounting for 18.2% of cases. There was a statistically significant difference in mean radiation dose (D{sub mean}) cochlea according to degree of ototoxicity, with D{sub mean} cochlea increasing with severity of hearing loss (p = 0.027). Conclusions: Severe ototoxicity was seen in 18.2% of ears in children treated with IMRT boost and cisplatin-based chemotherapy. Increasing dose to the cochlea was associated with increasing severity of hearing loss.

  4. The association of Raynaud's syndrome with cisplatin-based chemotherapy - a meta-analysis.

    PubMed

    Mohokum, Melvin; Hartmann, Peter; Schlattmann, Peter

    2012-10-01

    Vasospastic disorders of the digital circulation such as the Raynaud's syndrome (RS) are known side-effects of treatment of cisplatin-based chemotherapy. The prevalence of RS in patients during treatment with cisplatin-based chemotherapy is not well-defined. The objective of this paper was to assess the prevalence of RS in patients receiving cisplatin-based chemotherapy - a meta-analysis of published data was performed. The PubMed database of the National Library of Medicine and ISI Web of Knowledge was used for studies dealing with RS and patients receiving cisplatin-based chemotherapy. The studies provided sufficient data to estimate the prevalence of RS in patients receiving cisplatin-based chemotherapy. A forest plot was determined by the revealed prevalences. Statistical analysis was based on methods for a random effects meta-analysis and a finite mixture model for proportions. Publication bias was investigated with the linear regression test (Egger's method). A meta-regression was conducted by the year of publication and latitude. 24 eligible studies, contributing data on 2749 subjects, were included in this meta-analysis. For RS in patients receiving cisplatin-based chemotherapy a pooled prevalence of 24% and 95% CI (0.175, 0.313) was obtained. A mixture model analysis found four latent classes. Statistically, publication bias was not present (p-value 0.74). The meta-regression indicated that the odds ratio increased when the latitude increased, too (p-value 0.011). Despite some heterogeneity there is a possible indication of an association between RS and patients receiving cisplatin-based chemotherapy. Copyright © 2012 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  5. Prognostic factors in patients with metastatic germ cell tumors who experienced treatment failure with cisplatin-based first-line chemotherapy.

    PubMed

    Lorch, Anja; Beyer, Jörg; Bascoul-Mollevi, Caroline; Kramar, Andrew; Einhorn, Lawrence H; Necchi, Andrea; Massard, Christophe; De Giorgi, Ugo; Fléchon, Aude; Margolin, Kim A; Lotz, Jean-Pierre; Germa Lluch, Jose Ramon; Powles, Thomas; Kollmannsberger, Christian K

    2010-11-20

    To develop a prognostic model in patients with germ cell tumors (GCT) who experience treatment failure with cisplatin-based first-line chemotherapy. Data from 1,984 patients with GCT who progressed after at least three cisplatin-based cycles and were treated with cisplatin-based conventional-dose or carboplatin-based high-dose salvage chemotherapy was retrospectively collected from 38 centers/groups worldwide. One thousand five hundred ninety-four (80%) of 1,984 eligible patients were randomly divided into a training set of 1,067 patients (67%) and a validation set of 527 patients (33%). Seminomas were set aside for posthoc analyses. Primary end point was the 2-year progression-free survival after salvage treatment. Overall, 990 patients (62%) relapsed and 604 patients (38%) remained relapse free. Histology, primary tumor location, response, and progression-free interval after first-line treatment, as well as levels of alpha fetoprotein, human chorionic gonadotrophin, and the presence of liver, bone, or brain metastases at salvage were identified as independent prognostic variables and used to build a prognostic model in the training set. Survival rates in the training and validation set were very similar. The estimated 2-year progression-free survival rates in patients not included in the training set was 75% in very low risk, 51% in low risk, 40% in intermediate risk, 26% in high risk, and only 6% in very high-risk patients. Due to missing values in individual variables, 69 patients could not reliably be classified into one of these categories. Prognostic variables are important in patients with GCT who experienced treatment failure with cisplatin-based first-line chemotherapy and can be used to construct a prognostic model to guide salvage strategies.

  6. Prometheus' spirit: quality survival in advanced hepatocellular carcinoma after gemcitabine and cisplatin-based chemotherapy.

    PubMed

    Doval, D C; Pande, S B; Sharma, J B; Pavithran, K; Jena, A; Vaid, A K

    2008-10-01

    In advanced virus-induced hepatocellular carcinoma (HCC) associated with cirrhosis, the average survival is four months. We report a 56-year-old man with a large-volume advanced HCC, in whom gemcitabine and cisplatin-based chemotherapy resulted in near-complete regression, and quality survival of 24 months.

  7. Management of Chemotherapy Induced Nausea and Vomiting in Patients on Multiday Cisplatin Based Combination Chemotherapy

    PubMed Central

    Ranganath, Praveen; Einhorn, Lawrence; Albany, Costantine

    2015-01-01

    Introduction of cisplatin based chemotherapy has revolutionized the treatment of germ cell tumors. A common side effect of multiday cisplatin chemotherapy is severe nausea and vomiting. Considerable progress has been made in the control of these side effects since the introduction of cisplatin based chemotherapy in the 1970s. Germ cell tumor which is a model for a curable neoplasm has also turned into an excellent testing ground to develop effective strategies to prevent chemotherapy induced nausea and vomiting (CINV) in multiday cisplatin based regimens. The use of combination of a 5-hydroxytryptamine (HT)3 receptor antagonist, a neurokinin-1 (NK1) antagonist, and dexamethasone has greatly improved our ability to prevent and control acute and delayed CINV. Mechanism and pattern of CINV with multiday chemotherapy may differ from those in single day chemotherapy and therefore efficacy of antiemetic drugs as observed in single day chemotherapy may not be applicable. There are only few randomized clinical trials with special emphasis on multiday chemotherapy. Further studies are essential to determine the efficacy, optimal dose, and duration of the newer agents and combinations in multiday cisplatin based chemotherapy. PMID:26425563

  8. Relative Contributions of Radiation and Cisplatin-Based Chemotherapy to Sensorineural Hearing Loss in Head-and-Neck Cancer Patients

    SciTech Connect

    Hitchcock, Ying J. Tward, Jonathan D.; Szabo, Aniko; Bentz, Brandon G.; Shrieve, Dennis C.

    2009-03-01

    Purpose: To investigate the risk of sensorineural hearing loss (SNHL) in patients with head-and-neck cancer and treated with radiation therapy (RT) or concomitant cisplatin-based chemoradiation, the relationship among SNHL and radiation dose to the cochlea, the use of two common cisplatin dose regimens. Methods and Materials: A total of 62 head-and-neck cancer patients treated with curative intent were included in this prospective study. Of the patients, 21 received RT alone, 27 received 40 mg/m{sup 2} weekly cisplatin, 13 received 100 mg/m{sup 2} every 3 weeks during RT, and 1 received RT with weekly epidermal growth factor receptor inhibitor antibody. The effect of chemotherapy and RT dose on hearing was determined using a model that accounted for the age and variability between each ear for each patient. Results: We constructed a model to predict dose-dependent hearing loss for RT or cisplatin-based chemotherapy either alone or in combination. For patients only receiving RT, no significant hearing loss was found at doses to the cochlea of less than 40 Gy. Patients receiving 100 mg/m{sup 2} or 40 mg/m{sup 2} of cisplatin chemotherapy had an estimated +21.5 dB and +9.5 dB hearing loss at 8,000 Hz with low radiation doses (10 Gy), which rose to +38.4 dB and +18.9 dB for high radiation doses (40 Gy). Conclusions: Use of RT alone with doses of less than 40 Gy did not result in clinically significant hearing loss. High-frequency SNHL was profoundly damaged in patients who received concomitant cisplatin when doses of 100 mg/m{sup 2} were used. The threshold cochlear dose for hearing loss with cisplatin-based chemotherapy and RT was predicted to be 10 Gy. The inner ear radiation dose constraints and cisplatin dose intensity should be considered in the treatment of advanced head-and-neck cancer.

  9. Efficacy of oral palonosetron compared to intravenous palonosetron for the prevention of chemotherapy-induced nausea and vomiting associated with moderately emetogenic chemotherapy: a phase 3 trial.

    PubMed

    Boccia, Ralph; Grunberg, Steven; Franco-Gonzales, Edwin; Rubenstein, Edward; Voisin, Daniel

    2013-05-01

    Palonosetron (Aloxi(®), Onicit(®)) is a pharmacologically unique 5-HT3 receptor antagonist (RA) approved as a single IV injection for the prevention of nausea and vomiting induced by chemotherapy (CINV) of either moderate or highly emetogenic potential (MEC and HEC, respectively). An oral palonosetron formulation has been developed and compared to the IV formulation. In this multinational, multicenter, double-blind, double-dummy, dose-ranging trial, 651 patients were randomly assigned to receive one of the following as a single dose prior to moderately emetogenic chemotherapy: oral palonosetron 0.25, 0.50, and 0.75 mg or IV palonosetron 0.25 mg. Patients were also randomized (1:1) to receive dexamethasone 8 mg IV or matched placebo on day 1. The primary endpoint was complete response (CR; no emesis, no rescue therapy) during the acute phase (0-24 h). Acute CR rates were 73.5, 76.3, 74.1, and 70.4 % for all patients receiving the palonosetron 0.25, 0.50, and 0.75 mg oral doses, and for IV palonosetron 0.25 mg, respectively; delayed CR (24-120 h) rates were 59.4, 62.5, 60.1, and 65.4 %, and overall CR (0-120 h) rates were 53.5, 58.8, 53.2, and 59.3 %, respectively. The addition of dexamethasone improved emetic control (acute CR rate) by at least 15 % for all groups except oral palonosetron 0.25 mg, where the acute CR improvement was approximately 7 %. Adverse events were similar in nature, incidence, and intensity for all oral and IV palonosetron groups, and were the expected adverse events for 5-HT3 RAs (primarily headache and constipation). Oral palonosetron has a similar efficacy and safety profile as IV palonosetron 0.25 mg and may be the preferred formulation in certain clinical situations. Among the tested oral treatments, a palonosetron 0.50-mg oral dose has been favored for the prevention of CINV in patients receiving moderately emetogenic chemotherapy due to a numerical gain in efficacy without a side effect disadvantage.

  10. [Emetogenic potential of antineoplastic agents based on clinical trials in Japan].

    PubMed

    Watanabe, Tomoki; Handa, Satoko; Kato, Yasuhisa

    2015-03-01

    Chemotherapy-induced nausea and vomiting (CINV) is one of the most common and distressing side effects of chemotherapy that decreases patients' quality of life and motivation for treatment. Therefore, prevention and treatment of CINV are essential for motivating patients to continue chemotherapy. International societies such as American Society of Clinical Oncology (ASCO), Multinational Association of Supportive Care in Cancer (MASCC)/European Society for Medical Oncology (ESMO), and National Comprehensive Cancer Network (NCCN) have published guidelines for using antiemetics, and these guidelines were published in Japan in May 2010. However, both the Japananese and international guidelines do not provide sufficient clinical trial-based evidence for antiemetic use in the Japanese population. In this study, we attempted to evaluate and clarify the frequency of CINV in clinical trials in Japan. We found that thet guidelines specify different emetogenic potentials of some antineoplastic agents such as gemcitabine. Therefore, we believe that it is necessary to reevaluate the emetogenic risk of such antineoplastic agents and to develop a practical and standard antiemetic therapy so that in the future, patients do not hesitate to undergo chemotherapy because of side effects.

  11. Safety and efficacy of a continuous infusion, patient-controlled antiemetic pump for children receiving emetogenic chemotherapy.

    PubMed

    Jones, Emma; Koyama, Tatsuki; Ho, Richard H; Kuttesch, John; Shankar, Sadhna; Whitlock, James A; Cartwright, Julia; Frangoul, Haydar

    2007-03-01

    Chemotherapy-induced nausea and vomiting (CINV) is one of the most distressing side effects of moderately or highly emetogenic chemotherapy. Diphenhydramine, lorazepam, and dexamethasone have been used individually to treat CINV. The objective of this study was to evaluate the safety and potential efficacy of those drugs administered via a patient controlled pump (BAD pump) to control CINV. A retrospective chart review was conducted of all pediatric oncology patients who received the BAD pump. Emetic episodes, doses of rescue medications to treat breakthrough nausea or vomiting, and occurrence of adverse events were recorded. Complete response (CR) was defined as no emesis or rescue medications, partial response (PR) as emesis but no rescue medications, and failure (F) as rescue medications required. Thirty patients received a total of 141 courses. Adverse events occurred in 4.2% of the courses; confusion (n = 2), depressed mood (n = 1), dysphoria (n = 1), agitation (n = 1), and restlessness (n = 1). All side effects resolved after decreasing the infusion rate, and the pump was not discontinued in any patients. Eighteen patients failed conventional prophylaxis and received BAD pump for identical subsequent chemotherapy cycles; they spent more days in CR with BAD pump than without it, 21 versus 45 days (P = .003) respectively. Patients receiving BAD pump had significantly shorter hospital stay with BAD pump than those not receiving it, 68 days versus 76 (P = .046). BAD pump is well tolerated in pediatric patients receiving chemotherapy and may be more effective than conventional prophylaxis in controlling CINV in some patients. (c) 2006 Wiley-Liss, Inc.

  12. Survival of patients with advanced urothelial cancer treated with cisplatin-based chemotherapy.

    PubMed Central

    Fosså, S. D.; Sternberg, C.; Scher, H. I.; Theodore, C. H.; Mead, B.; Dearnaley, D.; Roberts, J. T.; Skovlund, E.

    1996-01-01

    The aim of the present retrospective study was to assess long-term survival after cisplatin-based chemotherapy in 398 patients with advanced urothelial transitional cell carcinoma (TCC) treated at seven international oncological units. Various combinations of cisplatin, methotrexate, vinblastine (or vincristine) and doxorubicin were used. The complete response rate according to the WHO criteria was 17%. Partial responses were obtained in 42% of the patients. The overall cancer-related 2 year and 5 year survival rates were 21% and 11% respectively. Based on multivariate analyses, a good prognosis group could be identified comprising patients with a good performance status with disease confined to lymph nodes (14%) or patients with T4b disease only. These patients had a 28% 5 year survival rate, which, in part, has to be related to post-chemotherapy consolidation treatment in patients with pelvis-confined disease (radiotherapy, 26%; total cystectomy, 11%). Fifteen patients died of chemotherapy-related complications and in 16% of the patients toxicity led to discontinuation of treatment. Modern cisplatin-based chemotherapy leads to long-term survival and cure of selected patients with advanced urothelial transitional cancer. In routine clinical practice, chemotherapy should be offered to good prognosis patients; those presenting with a good performance status and a non-metastasising T4b tumour or with metastases confined to lymph nodes. Post-chemotherapy consolidation treatment by surgery or radiotherapy should always be considered. Such chemotherapy requires oncological expertise in order to avoid unnecessary toxicity. PMID:8932351

  13. Evaluating the Effect of Zingiber Officinalis on Nausea and Vomiting in Patients Receiving Cisplatin Based Regimens

    PubMed Central

    Fahimi, Fanak; Khodadad, Kian; Amini, Somayeh; Naghibi, Farzaneh; Salamzadeh, Jamshid; Baniasadi, Shadi

    2011-01-01

    Ginger, the rhizome of Zingiber officinalis, has long been used as herbal medicine for its antiemetic effect. For evaluating the effect of zingiber officinalis on nausea and vomiting (N and V) in patients receiving cisplatin based regimens, a randomized double-blind placebo-controlled cross-over clinical trial was carried out in patients receiving cisplatin in combination with other chemotherapeutic agents. The patients were randomly assigned to receive ginger capsules (rhizome of zingiber officinalis) or placebo in their first cycle of the study. All patients received standard antiemetics for chemotherapy induced nausea and vomiting (CINV). The patients were crossed-over to receive ginger or placebo in their next cycle of chemotherapy. Among 36 eligible patients who received both cycles of treatment, there were no difference in prevalence, severity, and duration of both acute and delayed N and V. Addition of ginger to the standard antiemetic regimen has shown no advantage in reducing acute and delayed N and V in patients with cisplatin-based regimen in this study. PMID:24250368

  14. Prophylactic treatment for delayed chemotherapy-induced nausea and vomiting after non-AC based moderately emetogenic chemotherapy: a systematic review of randomized controlled trials.

    PubMed

    van der Vorst, Maurice J D L; Neefjes, Elisabeth C W; Konings, Inge R H M; Verheul, Henk M W

    2015-08-01

    Delayed chemotherapy-induced nausea and vomiting (CINV) remains an important adverse effect of moderately emetogenic chemotherapy not containing anthracyclines and cyclophosphamide (non-AC MEC). In this review, we summarize current literature to update recommendations for delayed CINV prophylaxis after non-AC MEC. We conducted a systematic search in PubMed and conference proceedings from ASCO, ESMO, and MASCC. Included randomized controlled trials (RCTs) aimed to prospectively evaluate the efficacy of two or more antiemetic strategies in the prevention of delayed CINV after the administration of non-AC MEC. At least one of the following endpoints was used: complete response, complete control, no nausea, no vomiting, and/or no use of rescue medication. Our search provided 247 publications. Nine met the predefined criteria. Included RCTs reported outcomes on palonosetron, aprepitant, casopitant, netupitant/palonosetron (NEPA), olanzapine, and megestrol acetate. Superiority of palonosetron over first-generation 5-HT3 receptor antagonists for the prevention of acute and delayed CINV after non-AC MEC has not been proven. The addition of an NK1 receptor antagonist to first-generation 5-HT3 receptor antagonists does not significantly improve the incidence of delayed CINV after non-AC MEC. The efficacy of a single-day regimen of dexamethasone with palonosetron is non-inferior to multiday dexamethasone. NEPA, olanzapine, and megestrol acetate show highly effective complete response (CR) rates.

  15. Comparison between 5-day aprepitant and single-dose fosaprepitant meglumine for preventing nausea and vomiting induced by cisplatin-based chemotherapy.

    PubMed

    Ando, Yosuke; Hayashi, Takahiro; Ito, Kaori; Suzuki, Eri; Mine, Naoyuki; Miyamoto, Ayumi; Oya, Miyuki; Matsuda, Hidezo; Isaji, Ami; Nakanishi, Toru; Imaizumi, Kazuyoshi; Shibata, Tomoyuki; Okada, Tatsuyoshi; Sakurai, Kazuo; Naito, Kensei; Uyama, Ichiro; Kawada, Kenji; Takahashi, Hiroshi; Yamada, Shigeki

    2016-02-01

    We aimed to compare the preventive effect of 5-day administration of aprepitant with single administration of fosaprepitant meglumine against nausea and vomiting symptoms due to highly emetogenic chemotherapy regimens comprising cisplatin (CDDP). Subjects were inpatients who underwent chemotherapy for gastric cancer, esophageal cancer, lung cancer, or head and neck cancer with a regimen comprising 60 mg/m(2) or higher dose of CDDP. In this randomised, open-label, controlled study, the subjects were assigned to a group given aprepitant for 5 days or a group given a single administration of fosaprepitant meglumine. The nausea and vomiting symptoms that emerged within 7 days after the first CDDP administration were investigated with a questionnaire form; the results were compared between the two groups. Risk factors affecting nausea and vomiting symptoms were also investigated. Of the 101 patients enrolled, 93 patients were included (48 in the 5-day aprepitant group and 45 in the single fosaprepitant meglumine group). No significant intergroup differences in the complete response rate or the complete control rate were found over the entire period. The nausea score tended to increase from day 3 in both groups, but no significant intergroup difference was observed. Furthermore, the investigation of risk factors affecting moderate or severe nausea symptoms indicated that the fosaprepitant meglumine administration was not a risk factor. Single administration of fosaprepitant meglumine was not inferior to 5-day administration of aprepitant for preventing acute and delayed nausea and vomiting symptoms occurring after administration of CDDP (60 mg/m(2) or higher).

  16. A risk-adapted strategy of radiotherapy or cisplatin-based chemotherapy in stage II seminoma.

    PubMed

    Domont, Julien; Massard, Christophe; Patrikidou, Anna; Bossi, Alberto; de Crevoisier, Renaud; Rose, Mathieu; Wibault, Pierre; Fizazi, Karim

    2013-07-01

    Indications for radiotherapy and chemotherapy in stage II seminoma are currently debated. Since 1980, the policy at Institut Gustave Roussy was to treat patients with stage IIA-B disease with external radiotherapy and patients with stage IIB-C with cisplatin-based chemotherapy. In stage IIB disease, 3 cm was the usual tumor size threshold above which individual patients were considered for chemotherapy. During the period 1980-2001, 67 patients with stage II seminoma were treated: stage IIA (n = 5), stage IIB (n = 31), and stage IIC (n = 31). The median age was 40 years (range: 23-64). Among 37 patients who received radiotherapy, 5, 28, and 4 had a stage IIA, IIB, and IIC, respectively. Among 30 patients who received chemotherapy, 27 had a stage IIC. With a median follow-up of 9.4 years, 19 relapses (28%) occurred, including 11 and 8 cases treated with radiotherapy (30%) and chemotherapy (27%), respectively. The 5-year relapse-free survival was 71% (95% CI: 59-80). All but three relapses were salvaged with chemotherapy followed in selected cases by surgical resection of residual masses. Only 3 patients died of seminoma. The 5-year overall survival rate is 97% (95% CI: 89-99). Five patients subsequently developed a non-germ-cell second cancer, which occurred within the radiation field in 3 cases. With an overall survival rate of 97%, the overall outcome of patients with stage II seminoma managed according to this risk-adapted strategy is good. The possibility of extending the indications for chemotherapy to selected stage IIB seminoma patients needs to be further evaluated as potentially beneficial in terms of relapse risk. Copyright © 2013 Elsevier Inc. All rights reserved.

  17. Risk factors associated with ineligibility of adjuvant cisplatin-based chemotherapy after nephroureterectomy

    PubMed Central

    Shao, I-Hung; Lin, Yu-Hsiang; Hou, Chen-Pang; Juang, Horng-Heng; Chen, Chien-Lun; Chang, Phei-Lang; Tsui, Ke-Hung

    2014-01-01

    Purpose Radical nephroureterectomy (RNU) is a standard treatment for upper urinary tract urothelial carcinoma. However, RNU can result in decreased renal function and cannot be treated with adjuvant chemotherapy. We performed a risk group stratification analysis to determine the preoperative factors that are predictive of diminished renal function after RNU. Materials and methods We retrospectively evaluated the medical records of all patients who underwent nephroureterectomy for upper urinary tract urothelial carcinoma at the Chang Gung Memorial Hospital from 2001 to 2008. We analyzed the association between perioperative glomerular filtration rate and preoperative parameters including cancer characteristics, serum creatinine level, and kidney size measured on computed tomographic images. Results A total of 242 patients fulfilled the inclusion criteria. The average decrease in renal function 1 month after RNU was 19.7%. Using 60 mL/min/1.73 m2 as the eligibility cutoff for cisplatin-based chemotherapy, 42.1% of the population was eligible prior to nephroureterectomy, whereas following surgery only 15.2% remained eligible. Using a cutoff of 45 mL/min/1.73 m2, 59.9% of the cohort was eligible for fractionated cisplatin dosing preoperatively, whereas only 32.6% remained above the cutoff postoperatively. The most significant predictors of poor postoperative renal function were body mass index >25 kg/m2, age >65 years, contralateral kidney length less than 10 cm, and absence of ipsilateral hydronephrosis. Conclusion Our results suggest that older age, higher body mass index, smaller contralateral renal length, and absence of ipsilateral hydronephrosis are predictive of decreased renal function after RNU. PMID:25364228

  18. [Benefits of cisplatin-based polychemotherapy in non-small cell bronchogenic carcinoma. Kyushu Lung Cancer Chemotherapy Study Group].

    PubMed

    Ohta, M; Hara, N; Ichikawa, Y; Kanda, T; Shima, K; Tamura, K; Hokama, M

    1988-06-01

    We studied the efficacy of cisplatin-based polychemotherapy for non-small-cell lung cancer. One hundred nineteen patients with adenocarcinoma or large cell carcinoma were randomized to receive cyclophosphamide, adriamycin, cisplatin and mitomycin C (CAPM) or mitomycin C, cytosine arabinoside and tegafur (MCT), and 48 patients with squamous cell carcinoma were randomized to receive cisplatin, adriamycin and peplomycin (PAP) or mitomycin C, cyclophosphamide, tespamine, toyomycin and tegafur (MCTTT). Radiation was given to the chest in patients with stage I-III disease. The response rates were CAPM, 34.5%; MCT, 13.1% (p less than 0.01) and PAP, 63.3%; MCTTT, 42.3%. A significant difference in response rate between the CAPM and MCT regimens was observed only in stage IV patients and not in stage I-III patients. The median survival was 9.5 months in the CAPM arm vs. 6.5 months in the MCT arm (p less than 0.007), and 8.5 months in the PAP arm vs. 6.5 months in the MCTTT arm. Improved median survival for the CAPM regimen was noted only in stage IV patients and not in stage I-III patients when compared to patients given the MCT regimen, respectively. Nausea and vomiting were significantly increased in patients with cisplatin-based polychemotherapy. Myelosuppression was more severe with the CAPM regimen than with the other chemotherapy regimens. We concluded that cisplatin-based polychemotherapy, CAPM and PAP therapy were of more benefit to patients with disseminated non-small-cell lung cancer than MCT and MCTTT therapy.

  19. Possible involvement of β₁ receptors in various emetogen-induced increases in salivary amylase activity in rats.

    PubMed

    Fukui, Hideo; Suyama, Yoshimi; Iwachido, Takako; Miwa, Eri

    2011-01-01

    We investigated the inhibitory effects of β₁- or β₂-adrenoceptor (AR) antagonists on salivary amylase secretion produced by various emetic agents, such as cisplatin, apomorphine, and lithium chloride (LiCl), or the non-emetic agent β(½)-AR agonist isoprenaline in rats. We also determined the inhibitory effect of metoclopramide, a dopamine D₂-receptor antagonist, on increases in the salivary amylase activity induced by apomorphine or granisetron, a 5-HT(3)-receptor antagonist, on LiCl-induced increased salivary amylase activity. Isoprenaline (0.01 mg/kg, s.c.) produced an increase in salivary amylase and the increase was inhibited by the β(½)-AR antagonist propranolol (5 mg/kg, s.c.) and β₁-AR antagonist atenolol (2 mg/kg, s.c.) but not by the β₂-AR antagonist butoxamine (8 mg/kg, s.c.). The increased amylase activity induced by cisplatin (15 mg/kg, i.v.), apomorphine (3 mg/kg, s.c.), or LiCl (120 mg/kg, i.p.) was inhibited significantly by atenolol (2 mg/kg, s.c.) but not by butoxamine (8 mg/kg, s.c.). In addition, increases in amylase activities induced by apomorphine and LiCl were inhibited significantly by metoclopramide (10 mg/kg, i.v.) and granisetron (3 mg/kg, i.v.), respectively. These results suggest that salivary amylase secretion induced by various emetogens is involved in β₁-adrenoceptor activity and that salivary amylase activity is useful to detect emetogens with no direct β₁-AR activation in rats, a species that does not exhibit vomiting.

  20. Administration of contrast media just before cisplatin-based chemotherapy increases cisplatin-induced nephrotoxicity.

    PubMed

    Sendur, M A N; Aksoy, S; Yaman, S; Arik, Z; Tugba Kos, F; Akinci, M B; Civelek, B; Yildirim Ozdemir, N; Uncu, D; Zengin, N

    2013-01-01

    There is a clinical need to predict the probability of cisplatin-induced nephrotoxicity (CIN) in order to make decisions about patient management and relevant preventive measures. The purpose of this study was to develop a risk prediction methodology of CIN. 197 consecutive cancer patients, whose serum creatinine was measured at least 48 h before every cycle of cisplatin-based chemotherapy, were included in the study. Demographic and clinical data were collected from the patient medical records. Renal function was evaluated at least 48 h before treatment (day 0) of each cycle, based on the Modification of Diet in Renal Disease (MDRD) formula. CIN was defined as a decrease of ≥ 25% in glomerular filtration rate (GFR) compared to baseline GFR values. The mean age of the study population was 54.5±9.6 years. Fifty-eight patients (29.4%) whose GFR had decreased by at least 25% compared to baseline values formed the CIN group, and the remaining 139 patients formed the non-CIN group. No significant differences were noted between the CIN and non-CIN groups in terms of age, gender, body mass index and smoking history. Metastatic disease was similar in both groups (p=0.86). History of hypertension (p=0.81), diabetes mellitus (p=0.72), and cardiovascular disease (p=0.58) were similar in the two groups. Chemotherapeutic agents used concurrently with cisplatin were similar in both groups. Significantly more radiologic examinations using contrast media were performed in the CIN group compared with the non-CIN group (p=0.01). In patients exposed to contrast media within a week before cisplatin administration, the risk of CIN was 2.56-fold higher (957 percent; CI 1.28-5.11) than in patients without such exposure (p=0.009). In patients with exposure to contrast media within a week before cisplatin administration, the risk of CIN was significantly higher than in patients without such an exposure. No additional risk factors for CIN were found in this retrospective observational

  1. Cost-effectiveness analysis of granisetron-based versus standard antiemetic regimens in low-emetogenic chemotherapy: a hospital-based perspective from Malaysia.

    PubMed

    Keat, Chan Huan; Ghani, Norazila Abdul

    2013-01-01

    In a prospective cohort study of antiemetic therapy conducted in Malaysia, a total of 94 patients received low emetogenic chemotherapy (LEC) with or without granisetron injections as the primary prophylaxis for chemotherapy-induced nausea and vomiting (CINV). This study is a retrospective cost analysis of two antiemetic regimens from the payer perspective. This cost evaluation refers to 2011, the year in which the observation was conducted. Direct costs incurred by hospitals including the drug acquisition, materials and time spent for clinical activities from prescribing to dispensing of home medications were evaluated (MYR 1=$0.32 USD). As reported to be significantly different between two regimens (96.1% vs 81.0%; p=0.017), the complete response rate of acute emesis which was defined as a patient successfully treated without any emesis episode within 24 hours after LEC was used as the main indicator for effectiveness. Antiemetic drug acquisition cost per patient was 40.7 times higher for the granisetron-based regimen than for the standard regimen (MYR 64.3 vs 1.58). When both the costs for materials and clinical activities were included, the total cost per patient was 8.68 times higher for the granisetron-based regimen (MYR 73.5 vs 8.47). Considering the complete response rates, the mean cost per successfully treated patient in granisetron group was 7.31 times higher (MYR 76.5 vs 10.5). The incremental cost-effectiveness ratio (ICER) with granisetron-based regimen, relative to the standard regimen, was MYR 430.7. It was found to be most sensitive to the change of antiemetic effects of granisetron-based regimen. While providing a better efficacy in acute emesis control, the low incidence of acute emesis and high ICER makes use of granisetron as primary prophylaxis in LEC controversial.

  2. Taste and smell function in testicular cancer survivors treated with cisplatin-based chemotherapy in relation to dietary intake, food preference, and body composition.

    PubMed

    IJpma, Irene; Renken, Remco J; Gietema, Jourik A; Slart, Riemer H J A; Mensink, Manon G J; Lefrandt, Joop D; Ter Horst, Gert J; Reyners, Anna K L

    2016-10-01

    Chemotherapy can affect taste and smell function. This may contribute to the high prevalence of overweight and metabolic syndrome in testicular cancer survivors (TCS). Aims of the study were to evaluate taste and smell function and possible consequences for dietary intake, food preference, and body composition in TCS treated with cisplatin-based chemotherapy. Fifty TCS, 1-7 years post-chemotherapy, and 50 age-matched healthy men participated. Taste and smell function were measured using taste strips and 'Sniffin' Sticks', respectively. Dietary intake was investigated using a food frequency questionnaire. Food preference was assessed using food pictures varying in taste (sweet/savoury) and fat or protein content. Dual-Energy X-ray Absorptiometry was performed to measure body composition. Presence of metabolic syndrome and hypogonadism were assessed. TCS had a lower total taste function, a higher bitter taste threshold, higher Body Mass Index (BMI), and more (abdominal) fat than controls (p < 0.05). No differences in smell function and dietary intake were found. Testosterone level was an important determinant of body composition in TCS (p = 0.016). Although taste function was impaired in TCS, this was not related to a different dietary intake compared to controls. Lower testosterone levels were associated with a higher BMI, fat mass, and abdominal fat distribution in TCS. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Amisulpride in the prevention of nausea and vomiting induced by cisplatin-based chemotherapy: a dose-escalation study.

    PubMed

    Herrstedt, Jørn; Summers, Yvonne; Daugaard, Gedske; Christensen, Thomas B; Holmskov, Karin; Taylor, Paul D; Fox, Gabriel M; Molassiotis, Alexander

    2017-08-11

    The purpose of this study was to investigate the antiemetic effect of the dopamine D2- and dopamine D3-receptor antagonist, amisulpride, in patients receiving cisplatin-based chemotherapy. This dose-finding, non-comparative study investigated the antiemetic effect and safety of increasing doses (2.5, 7.5 and 20 mg) of amisulpride against acute nausea and vomiting in the period 0-24 h after initiation of cisplatin-based chemotherapy. The 20 mg dose was also investigated in combination with the 5-HT3-receptor antagonist, ondansetron. The primary parameter was complete response (0-24 h), defined as no emesis and no need for rescue antiemetics. Secondary parameters were number of emetic episodes, severity of nausea and time to first emetic episode and start of nausea. A total of 51 patients were enrolled and evaluable. None of the 10 patients in the 2.5 and 7.5 mg groups obtained a CR. In the 20 mg monotherapy cohort, two of the 18 subjects (11%) had a CR, 3/18 (17%) had no emesis and 12/18 (67%) had no significant nausea. Seven subjects (39%) had no nausea at all (a VAS score < 5 mm). In the combination (ondansetron plus amisulpride) cohort, 19/23 (83%; 90% confidence interval: 65-94%) had a CR and 14/23 (61%) had no nausea at all. Amisulpride has antiemetic effect against cisplatin-induced acute nausea and vomiting. The effect against nausea is of particular interest. Randomised studies are warranted to further explore the effect and safety of amisulpride.

  4. The benefit of cisplatin-based polychemotherapy for adenocarcinoma of the lung. The Kyushu Lung Cancer Chemotherapy Study Group.

    PubMed

    Hara, N; Ohta, M; Ichikawa, Y; Kanda, T; Shima, K; Tamura, K; Hokama, M

    1990-01-01

    We studied the efficacy of cisplatin-based polychemotherapy for adenocarcinoma of the lung. A total of 136 patients were randomized for treatment with either cyclophosphamide, Adriamycin, cisplatin and mitomycin C (CAPM) or mitomycin C, cytosine arabinoside and tegafur (MCT). Radiation was given to the chests of patients at stage III. The differences in the response rate (35% in the CAPM arm and 13% in the MCT arm) were statistically significant (P less than 0.01). However, the significant difference was observed in stage-IV patients (CAPM, 33%; MCT, 4%; P less than 0.001) and not in stage-III patients (CAPM, 40%; MCT, 40%). The median period of survival was 9.5 months for the CAPM arm and 5.5 months for the MCT arm (P less than 0.035, Wilcoxon-Gehan test; P less than 0.1, log-rank test). Improved median survival for the CAPM regimen was demonstrated only by stage-IV patients (CAPM, 10 months; MCT, 5.5 months; P less than 0.025, Wilcoxon-Gehan test; P less than 0.05, log-rank test). The duration of the response, including PRs and NCs, was significantly different depending on the treatment, showing 5 months for the CAPM arm and 3 months for the MCT arm (P less than 0.05). The significant difference was also only observed in stage-IV patients. Myelosuppression was more severe with CAPM than with the MCT regimen. Nausea and vomiting were significantly increased in patients receiving the CAPM regimen. However, all toxicities were acceptable and there were no treatment-related deaths. We concluded that cisplatin-based chemotherapy, CAPM therapy, was of more benefit to patients with adenocarcinoma of the lung than MCT therapy.

  5. [A meta-analysis of the curative effects of carboplatin-based and cisplatin-based chemotherapeutic regimens on advance non-small cell lung cancer].

    PubMed

    Jiang, Jing-wei; Liang, Xiao-hua; Zhou, Xin-li; Huang, Ruo-fan

    2006-10-10

    To evaluate whether there is a difference in the curative effect of carboplatin-based and cisplatin-based chemotherapeutic regimens on advance non-small cell lung cancer (NSCLC). The databases PudMed, CENTRAL, and Chinese biomedical database were retrieved by using the key words "non-small cell lung cancer" or "carcinoma, non-small cell lung" so as to search the materials about the randomized controlled clinical trials that had compared the curative effects of carboplatin-based and cisplatin-based chemotherapeutic regimens on advance NSCLC. A meta-analysis was conducted. Eighteen documents about randomized controlled clinical trials, including 6478 patients, from the retrieved 3531 documents accorded to the demand of enrollment. The overall response rates of the carboplatin-based and cisplatin-based chemotherapeutic groups were both 27% (RR = 0.93, 95% CI = 0.86 approximately 1.01, P = 0.10). Neither funnel plot nor rank correlation test regarding response rate indicated the existence of publication bias (chi(2) = 18.63, P = 0.63). The 0ne-year survival rate of the carboplatin-based regimen group was 36%, not significantly different from that of the cisplatin-based regimen group (35%, RR = 1.04, 95% CI = 0.93 - 1.17, P = 0.5). Sensitive analysis confirmed the non-existence of differences in the overall response rate and one-year survival rate between these 2 groups. The curative effects of the carboplatin-based and cisplatin-based chemotherapeutic regimens are similar. The choice of carboplatin or cisplatin depends on the toxicity of the drugs and the patients' tolerance.

  6. Changes in taste and smell function, dietary intake, food preference, and body composition in testicular cancer patients treated with cisplatin-based chemotherapy.

    PubMed

    IJpma, Irene; Renken, Remco J; Gietema, Jourik A; Slart, Riemer H J A; Mensink, Manon G J; Lefrandt, Joop D; Ter Horst, Gert J; Reyners, Anna K L

    2016-10-27

    Taste and smell changes due to chemotherapy may contribute to the high prevalence of overweight in testicular cancer patients (TCPs). This study investigates the taste and smell function, dietary intake, food preference, and body composition in TCPs before, during, and up to 1 year after cisplatin-based chemotherapy. Twenty-one consecutive TCPs participated. At baseline TCPs were compared to healthy controls (N = 48). Taste strips and 'Sniffin' Sticks' were used to determine psychophysical taste and smell function. Subjective taste, smell, appetite, and hunger were assessed using a questionnaire. Dietary intake was analyzed using a food frequency questionnaire. Food preference was assessed using food pictures varying in taste (sweet/savoury) and fat or protein content. A Dual-Energy X-ray Absorptiometry (DEXA) scan was performed to measure whole body composition. Compared to controls, TCPs had a lower smell threshold (P = 0.045) and lower preference for high fat sweet foods at baseline (P = 0.024). Over time, intra-individual psychophysical taste and smell function was highly variable. The salty taste threshold increased at completion of chemotherapy compared to baseline (P = 0.006). A transient decrease of subjective taste, appetite, and hunger feelings was observed per chemotherapy cycle. The percentage of fat mass increased during chemotherapy compared to baseline, while the lean mass and bone density decreased (P < 0.05). Coping strategies regarding subjective taste impairment should especially be provided during the first week of each chemotherapy cycle. Since the body composition of TCPs already had changed at completion of chemotherapy, intervention strategies to limit the impact of cardiovascular risk factors should probably start during treatment. Copyright © 2016 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  7. Palonosetron versus other 5-HT₃ receptor antagonists for prevention of chemotherapy-induced nausea and vomiting in patients with hematologic malignancies treated with emetogenic chemotherapy in a hospital outpatient setting in the United States.

    PubMed

    Craver, Chris; Gayle, Julie; Balu, Sanjeev; Buchner, Deborah

    2011-01-01

    This study evaluated the rate of uncontrolled chemotherapy-induced nausea and vomiting (CINV) after initiating antiemetic prophylaxis with palonosetron versus other 5-HT₃ receptor antagonists (RAs) in patients diagnosed with hematologic malignancies (lymphoma and leukemia) and receiving highly emetogenic chemotherapy (HEC) or moderately emetogenic chemotherapy (MEC) in a hospital outpatient setting. Patients aged ≥ 18 years and diagnosed with hematologic malignancies initiating HEC or MEC and antiemetic prophylaxis with palonosetron (Group 1) and other 5-HT₃ RAs (Group 2) for the first time in a hospital outpatient setting between 4/1/2007 and 3/31/2009 were identified from the Premier Perspective Database. Within each cycle, CINV events were identified (in the hospital outpatient, inpatient, and emergency room settings) through ICD-9 codes for nausea, vomiting, and/or volume depletion (from each CT administration day 1 until the end of the CT cycle), or use of rescue medications (day 2 until the end of the CT cycle). Negative binomial distribution generalized linear multivariate regression model estimating the CINV event rate on CT, specific CT cycles, and cancer diagnosis (leukemia/lymphoma)-matched groups in the follow-up period (first of 8 cycles or 6 months) was developed. Of 971 identified patients, 211 initiated palonosetron (Group 1). Group 1 patients comprised of more females [50.2 vs. 41.4%; p = 0.0226], Whites [74.4 vs. 70.4%, and Hispanics [7.6 vs. 6.3%; all races p = 0.0105], received more HEC treatments [89.6 vs. 84.2%; all CT types p = 0.0129], and had more lymphoma diagnosed patients [89.6 vs. 76.3%; all cancer types p = 0.0033] at baseline. After controlling for differences in several demographic and clinical variables, the regression model predicted a 20.4% decrease in CINV event rate per CT cycle for Group 1 versus Group 2 patients. Study limitations include potential lack of generalizability, absence of data on certain

  8. A randomized phase III study evaluating the efficacy and safety of NEPA, a fixed-dose combination of netupitant and palonosetron, for prevention of chemotherapy-induced nausea and vomiting following moderately emetogenic chemotherapy

    PubMed Central

    Aapro, M.; Rugo, H.; Rossi, G.; Rizzi, G.; Borroni, M. E.; Bondarenko, I.; Sarosiek, T.; Oprean, C.; Cardona-Huerta, S.; Lorusso, V.; Karthaus, M.; Schwartzberg, L.; Grunberg, S.

    2014-01-01

    Background Antiemetic guidelines recommend co-administration of agents that target multiple molecular pathways involved in emesis to maximize prevention and control of chemotherapy-induced nausea and vomiting (CINV). NEPA is a new oral fixed-dose combination of 300 mg netupitant, a highly selective NK1 receptor antagonist (RA) and 0.50 mg palonosetron (PALO), a pharmacologically and clinically distinct 5-HT3 RA, which targets dual antiemetic pathways. Patients and methods This multinational, randomized, double-blind, parallel group phase III study (NCT01339260) in 1455 chemotherapy-naïve patients receiving moderately emetogenic (anthracycline–cyclophosphamide) chemotherapy evaluated the efficacy and safety of a single oral dose of NEPA versus a single oral dose (0.50 mg) of PALO. All patients also received oral dexamethasone (DEX) on day 1 only (12 mg in the NEPA arm and 20 mg in the PALO arm). The primary efficacy end point was complete response (CR: no emesis, no rescue medication) during the delayed (25–120 h) phase in cycle 1. Results The percentage of patients with CR during the delayed phase was significantly higher in the NEPA group compared with the PALO group (76.9% versus 69.5%; P = 0.001), as were the percentages in the overall (0–120 h) (74.3% versus 66.6%; P = 0.001) and acute (0–24 h) (88.4% versus 85.0%; P = 0.047) phases. NEPA was also superior to PALO during the delayed and overall phases for all secondary efficacy end points of no emesis, no significant nausea and complete protection (CR plus no significant nausea). NEPA was well tolerated with a similar safety profile as PALO. Conclusions NEPA plus a single dose of DEX was superior to PALO plus DEX in preventing CINV following moderately emetogenic chemotherapy in acute, delayed and overall phases of observation. As a fixed-dose antiemetic drug combination, NEPA along with a single dose of DEX on day 1 offers guideline-based prophylaxis with a convenient, single-day treatment. PMID

  9. Biological activity of a series of cisplatin-based aliphatic bis(carboxylato) Pt(IV) prodrugs: how long the organic chain should be?

    PubMed

    Zanellato, Ilaria; Bonarrigo, Ilaria; Colangelo, Donato; Gabano, Elisabetta; Ravera, Mauro; Alessio, Manuela; Osella, Domenico

    2014-11-01

    The biological properties of a series of cisplatin-based Pt(IV) prodrug candidates, namely trans,cis,cis-[Pt(carboxylato)2Cl2(NH3)2], where carboxylato=CH3(CH2)nCOO(-) [(1), n=0; (2), n=2; (3), n=4; (4), n=6] having a large interval of lipophilicity are discussed. The stability of the complexes was tested in different pH conditions (i.e. from 1.0 to 9.0) to simulate the hypothetical conditions for an oral route of administration, showing a high stability (>90%). The transformation into their active Pt(II) metabolites was demonstrated in the presence of ascorbic acid, with a pseudo-first order kinetics, the half-time of which smoothly decreases as the chain length of carboxylic acid increases. Their antiproliferative activity has been evaluated in vitro on a large panel of human cancer cell lines. As expected, the potency increases with the chain length: 3 and 4 resulted by far more active than cisplatin on all cell lines of about one or two orders of magnitude, respectively. Both complexes retained their activity also on cisplatin-resistant cell line, and exhibited a progressive increase of the selectivity compared with non-tumor cells. These results were confirmed with more prolonged treatment (up to 14days) studied on multicellular tumor spheroids (MCTSs). In this case the Pt(IV) complexes exert a protracted antiproliferative action, even if the drug is removed from the culture medium. Finally, in a time-course experiment of the total platinum evaluation in mice blood (after a single oral administration of the title complexes), 2 gave the best results, representing a good compromise between lipophilicity and water solubility, that increase and decrease respectively on passing from 1 to 4.

  10. Multicenter phase IV study of palonosetron in the prevention of chemotherapy-induced nausea and vomiting (CINV) in patients with non-Hodgkin lymphomas undergoing repeated cycles of moderately emetogenic chemotherapy

    PubMed Central

    2014-01-01

    Antiemetic therapy for chemotherapy-induced nausea and vomiting in patients with non-Hodgkin lymphoma (NHL) receiving moderately emetogenic chemotherapy (MEC) generally includes a serotonin-type 3 (5-HT3) receptor antagonist (RA). The efficacy and safety of the second-generation 5-HT3 RA, palonosetron, in patients with NHL receiving MEC was assessed. Patients received a single iv bolus injection of 0.25 mg palonosetron and chemotherapy on day 1 of the first chemotherapy cycle, and up to three further consecutive cycles. Eighty-eight patients were evaluable for efficacy and safety. The primary endpoint, the percentage of patients with a complete response in the overall phase (0–120 h after chemotherapy in each cycle), increased from 68.2% (cycle 1) to 80.5% (cycle 2), remaining high for the following cycles, and > 90% patients were emesis-free without using aprepitant during therapy. Across all cycles, 78.4% of patients experienced treatment-emergent adverse events, but only 8% related to study drug, confirming palonosetron's good safety profile (EudraCT Number: 2008-007827-14). PMID:23772665

  11. Prevention of cisplatin-based chemotherapy-induced delayed nausea and vomiting using triple antiemetic regimens: a mixed treatment comparison

    PubMed Central

    Li, Hongjia; Le, Qiqi; Liu, Shanshan; Zong, Shaoqi; Zheng, Leizhen; Hou, Fenggang

    2016-01-01

    A variety of triple antiemetic regimens are being used to prevent cisplatin-based chemotherapy induced delayed emesis and nausea in cancer patients. We performed a network meta-analysis to compare the efficacies of the different regimens. Electronic searches of the PubMed, Cochrane Library and MEDLINE databases were performed to identify randomized controlled trials, and data were analyzed using JAGS, Stata 14.0 and R project. The primary outcome was a complete response (CR). The secondary outcomes were no vomiting (NV) and no nausea (NN). Among the 398 studies identified, 10 were eligible and included, providing data on nine regimens. In the CR analysis, the absolute rank of netupitant + palonosetron + dexamethasone (NEPA) was 0.8579. In the NV and NN analyses, NEPA's absolute ranks were 0.8631 and 0.7902, respectively. The compliance of patients treated with rolapitant + granisetron + dexamethasone (RGD) was the best due to a low incidence of adverse events, and good compliance was also observed with NEPA. It was difficult to achieve good compliance with aprepitant + granisetron + dexamethasone (AGD). Overall, NEPA was the best regimen, and aprepitant + ondansetron + dexamethasone (AOD) is also worthy of recommendation because of its low cost and good effect. For patients with severe constipation, hiccups, asthenia and/or delayed nausea, RGD is worthy of consideration. PMID:27015550

  12. Prognostic Model for Predicting Survival of Patients With Metastatic Urothelial Cancer Treated With Cisplatin-Based Chemotherapy

    PubMed Central

    2013-01-01

    A prognostic model that predicts overall survival (OS) for metastatic urothelial cancer (MetUC) patients treated with cisplatin-based chemotherapy was developed, validated, and compared with a commonly used Memorial Sloan-Kettering Cancer Center (MSKCC) risk-score model. Data from 7 protocols that enrolled 308 patients with MetUC were pooled. An external multi-institutional dataset was used to validate the model. The primary measurement of predictive discrimination was Harrell’s c-index, computed with 95% confidence interval (CI). The final model included four pretreatment variables to predict OS: visceral metastases, albumin, performance status, and hemoglobin. The Harrell’s c-index was 0.67 for the four-variable model and 0.64 for the MSKCC risk-score model, with a prediction improvement for OS (the U statistic and its standard deviation were used to calculate the two-sided P = .002). In the validation cohort, the c-indices for the four-variable and the MSKCC risk-score models were 0.63 (95% CI = 0.56 to 0.69) and 0.58 (95% CI = 0.52 to 0.65), respectively, with superiority of the four-variable model compared with the MSKCC risk-score model for OS (the U statistic and its standard deviation were used to calculate the two-sided P = .02). PMID:23411591

  13. Clinical outcomes following neoadjuvant cisplatin-based chemotherapy for bladder cancer in elderly compared with younger patients.

    PubMed

    Chau, C; Wheater, M; Geldart, T; Crabb, S J

    2015-03-01

    Bladder cancer is a disease of the elderly. Older patients might potentially be undertreated due to assumptions about benefit versus risk. Our objective was to determine outcomes in older patients receiving neoadjuvant chemotherapy for muscle-invasive bladder cancer (MIBC). We hypothesised that appropriately selected elderly patients (≥70 years) with MIBC could have similar clinical outcomes, and be safely treated, with standard neoadjuvant chemotherapy prior to definitive cystectomy or radiotherapy. We utilised a single institution case series analysis of patients with T2-4a N0 M0 transitional cell carcinoma of the bladder treated with cisplatin-based neoadjuvant chemotherapy between 2005 and 2011. Eighty-three patients were eligible. Median age was 68 (range 48-80), 33 patients (40%) were ≥70 years. Overall survival at 3 years was 65.8% (≥70) and 63.2% (<70) (P = 0.653), relapse-free survival at 3 years was 61.6% and 54.8% respectively (P = 0.471). The rates going forward to definitive local therapy (87.9% ≥ 70 and 84.0% < 70) and the pathological complete response rate (31.3% ≥ 70 and 40% < 70) were similar. Disease relapse rate was also similar (63.6% ≥ 70 vs. 60% < 70, P = 0.906). Elderly patients with good functional status and limited comorbidities diagnosed with MIBC receiving standard neoadjuvant chemotherapy followed by cystectomy or radiotherapy can have similar clinical outcomes as their younger counterparts. Prospective studies evaluating the optimum curative management in this elderly population are warranted.

  14. Results of a compassionate-use program using intravenous ondansetron to prevent nausea and vomiting in patients receiving emetogenic cancer chemotherapy.

    PubMed

    Berry, W R; House, K W; Lee, J T; Plagge, P B; Meshad, M W; Grapski, R

    1992-12-01

    This study reports the effectiveness and side effects of intravenous ondansetron as a single-agent antiemetic therapy for patients receiving emetogenic cancer chemotherapy under a compassionate-use program for patients not enrolled in controlled clinical trials. Patients were > or = 7 years old and had uncontrolled nausea and vomiting or intolerable side effects with standard antiemetics administered with previous cancer chemotherapy. All patients received ondansetron 0.15 mg/kg every 4 hours x 3 daily doses beginning 30 minutes prior to emetogenic chemotherapy. Patients could receive ondansetron for up to 5 consecutive days of chemotherapy. One hundred ninety patients received ondansetron during chemotherapy treatments that were similar to previous cycles of chemotherapy during which the patients had received standard antiemetics (identical chemotherapy or differing only by addition/deletion of chemotherapy agents of low emetogenicity). Chemotherapy regimens included cisplatin (n = 99; 52%), doxorubicin (without cisplatin, n = 52; 27%), and other drugs (n = 39; 21%). Patient experiences with nausea and vomiting and side effects with ondansetron and with previous standard antiemetics were rated on a scale of 1 to 10 (1, did not experience; 10, as bad as could be). On the nausea and vomiting scale, 74% of patients improved on ondansetron relative to standard antiemetics. Mean nausea and vomiting scales were 3.9 for ondansetron and 7.7 for standard antiemetics (P < .001). On the side effects scale, 62% of patients improved with ondansetron. Mean side effect scores were 1.8 for ondansetron and 4.5 for standard antiemetics (P < .001). One hundred nine patients assessed the effect of nausea and vomiting on their quality of life by means of the Functional Living Index-Emesis. On a 100-point scale (100=best quality of life), quality of life scores were 65.5 for ondansetron and 39.5 for standard antiemetics (P < .01). Functional Living Index-Emesis scores were higher for

  15. Mitochondrial Transcription Factor A and Mitochondrial Genome as Molecular Targets for Cisplatin-Based Cancer Chemotherapy.

    PubMed

    Kohno, Kimitoshi; Wang, Ke-Yong; Takahashi, Mayu; Kurita, Tomoko; Yoshida, Yoichiro; Hirakawa, Masakazu; Harada, Yoshikazu; Kuma, Akihiro; Izumi, Hiroto; Matsumoto, Shinji

    2015-08-20

    Mitochondria are important cellular organelles that function as control centers of the energy supply for highly proliferative cancer cells and regulate apoptosis after cancer chemotherapy. Cisplatin is one of the most important chemotherapeutic agents and a key drug in therapeutic regimens for a broad range of solid tumors. Cisplatin may directly interact with mitochondria, which can induce apoptosis. The direct interactions between cisplatin and mitochondria may account for our understanding of the clinical activity of cisplatin and development of resistance. However, the basis for the roles of mitochondria under treatment with chemotherapy is poorly understood. In this review, we present novel aspects regarding the unique characteristics of the mitochondrial genome in relation to the use of platinum-based chemotherapy and describe our recent work demonstrating the importance of the mitochondrial transcription factor A (mtTFA) expression in cancer cells.

  16. Comparison of Four Cisplatin-Based Radiochemotherapy Regimens for Nonmetastatic Stage III/IV Squamous Cell Carcinoma of the Head and Neck;Head-and-neck cancer; Cisplatin-based radiochemotherapy; Toxicity; Treatment outcomes

    SciTech Connect

    Rades, Dirk; Kronemann, Stefanie; Meyners, Thekla; Bohlen, Guenther; Tribius, Silke; Kazic, Nadja; Schroeder, Ursula; Hakim, Samer G.; Schild, Steven E.; Dunst, Juergen

    2011-07-15

    Purpose: To compare the outcomes of four cisplatin-based radiochemotherapy regimens in 311 patients with Stage III/IV squamous cell carcinoma of the head and neck. Methods and Materials: Concurrent chemotherapy consisted of three courses of cisplatin 100 mg/m{sup 2} on Day 1 (Group A, n = 74), two courses of cisplatin 20 mg/m{sup 2} on Days 1-5 plus 5-fluorouracil 1,000 mg/m{sup 2} on Days 1-5 (Group B, n = 49), two courses of cisplatin 20 mg/m{sup 2} on Days 1-5 plus 5-fluorouracil 600 mg/m{sup 2} on Days 1-5 (Group C, n = 102), or two courses of cisplatin 20 mg/m{sup 2} on Days 1-5 (Group D, n = 86). The groups were retrospectively compared for toxicity and outcomes, and 11 additional factors were evaluated for outcomes. Results: No significant difference was observed among the groups regarding radiation-related acute oral mucositis and radiation-related late toxicities. Acute Grade 3 skin toxicity was significantly more frequent in Group B than in the patients of the other three groups (p = .013). The chemotherapy-related Grade 3 nausea/vomiting rate was 24% for Group A, 8% for Group B, 9% for Group C, and 6% for Group D (p = .003). The corresponding Grade 3 nephrotoxicity rates were 8%, 1%, 2%, and 1% (p = .019). The corresponding Grade 3-4 hematologic toxicity rates were 35%, 41%, 19%, and 21% (p = .027). Chemotherapy could be completed in 50%, 59%, 74%, and 83% of the Group A, B, C, and D patients, respectively (p = .002). Toxicity-related radiotherapy breaks occurred in 39%, 43%, 21%, and 15% of Groups A, B, C, and D, respectively (p = .005). The 3-year locoregional control rate was 67%, 72%, 60%, and 59% for Groups A, B, C, and D, respectively (p = .48). The corresponding 3-year metastasis-free survival rates were 67%, 74%, 63%, and 79% (p = .31), and the corresponding 3-year survival rates were 60%, 63%, 50%, and 71% (p = .056). On multivariate analysis, Karnofsky performance status, histologic grade, T/N category, preradiotherapy hemoglobin level

  17. Significance of TP53 mutations as predictive markers of adjuvant cisplatin-based chemotherapy in completely resected non-small-cell lung cancer.

    PubMed

    Ma, Xiaoli; Rousseau, Vanessa; Sun, Haiji; Lantuejoul, Sylvie; Filipits, Martin; Pirker, Robert; Popper, Helmut; Mendiboure, Jean; Vataire, Anne-Lise; Le Chevalier, Thierry; Soria, Jean Charles; Brambilla, Elisabeth; Dunant, Ariane; Hainaut, Pierre

    2014-05-01

    Adjuvant cisplatin-based chemotherapy only marginally improves survival in patients with completely resected non-small-cell lung cancer (NSCLC). We have evaluated the predictive value of mutations in TP53, encoding the tumour suppressor p53, in the International Adjuvant Lung Cancer Trial (IALT), a randomized trial of adjuvant cisplatin-based chemotherapy against observation. TP53 (exons 4-8) was sequenced in 524 archived specimens of IALT patients with a median follow-up of 7.5 years. Predictive analyses were based on Cox models adjusted for clinical and pathological variables. P-values ≤ 0.01 were considered as significant. Mutations were detected in 221 patients (42%) and had no predictive value for the effect of chemotherapy (interaction between TP53 and treatment: p = 0.17 for Overall Survival (OS); p = 0.06 for Disease-Free Interval, (DFS)). However, among patients with mutations, outcome appeared worse in treatment compared to observation arms (HR for OS = 1.36 (95% CI [0.97-1.31), p = 0.08; DFS = 1.40 (95% CI [1.01-1.95]), p = 0.04). When grouping mutations into classes according to predicted effects on protein structure, the tendency towards worse outcomes was restricted to "structure" mutations affecting residues of the hydrophobic core that are not located at the p53 protein-DNA interface (HR for death in this class vs wild-type T53 = 1.66; 95% CI [1.10-2.52], p = 0.02). Overall, TP53 mutations are not significant predictors of outcome in this trial of cisplatin-based chemotherapy, although a specific class of structural mutations may be associated with a tendency towards worse outcomes upon treatment. Copyright © 2014 Federation of European Biochemical Societies. Published by Elsevier B.V. All rights reserved.

  18. Abdominal visceral and subcutaneous fat increase, insulin resistance and hyperlipidemia in testicular cancer patients treated with cisplatin-based chemotherapy.

    PubMed

    Willemse, Peter-Paul M; van der Meer, Rutger W; Burggraaf, Jacobus; van Elderen, Saskia G C; de Kam, Marieke L; de Roos, Albert; Lamb, Hildo J; Osanto, Susanne

    2014-03-01

    Testicular cancer survivors treated with chemotherapy are at increased risk for metabolic syndrome (MetS) and cardiovascular disease (CVD). We explored acute effects of chemotherapy by assessing metabolic factors, abdominal fat volume, hepatic triglyceride content (HTC) and aortic wall stiffness. We studied 19 testicular cancer patients (age 20-54 years) before, at three and nine months after the start of chemotherapy. Blood serum was analyzed for lipids, glucose and insulin. Abdominal visceral and subcutaneous fat volume and aortic pulse wave velocity were assessed by magnetic resonance imaging (MRI) techniques; HTC was measured by proton MR spectroscopy. Three months after start of chemotherapy visceral abdominal fat volume had significantly increased from 202 ± 141 to 237 ± 153 ml (p = 0.009) whereas body mass index and subcutaneous fat volume significantly increased nine months after treatment from 24.4 ± 4.0 to 26.4 ± 4.1 kg/m(2) (p = 0.01) and from 556 ± 394 to 668 ± 460 ml (p = 0.002) respectively. Serum total cholesterol, low-density lipoprotein cholesterol and insulin also significantly increased three months after start of treatment from 4.88 ± 1.1 to 5.61 ± 1.50 mmol/l (p = 0.002), 3.31 ± 1.16 to 3.73 ± 1.41 mmol/l (p = 0.02) and 5.7 ± 4.4 to 9.6 ± 6.3 mU/ml (p = 0.03), respectively. Nine months after start of chemotherapy serum lipid and insulin concentrations had returned to baseline. HTC increased in seven of the 19 patients (36.8%) during follow-up. Aortic pulse wave velocity remained unchanged at the three time points measured. Cisplatin-based chemotherapy was associated with acute insulin resistance, dyslipidemia and an immediate increase in abdominal visceral adipose tissue and abdominal subcutaneous adipose tissue in testicular cancer patients. A large prospective cohort study with long follow-up is warranted to characterize the time course and relationship between acutely induced obesity and hypercholesterolemia and the development

  19. Albumin-to-Alkaline Phosphatase Ratio: A Novel Prognostic Index of Overall Survival in Cisplatin-based Chemotherapy-treated Patients with Metastatic Nasopharyngeal Carcinoma

    PubMed Central

    Nie, Man; Sun, Peng; Chen, Cui; Bi, Xiwen; Wang, Yu; Yang, Hang; Liu, Panpan; Li, Zhiming; Xia, Yi; Jiang, Wenqi

    2017-01-01

    The Albumin-to-Alkaline Phosphatase Ratio (AAPR) has been recently revealed as a prognostic index for hepatocellular carcinoma, whereas its role in metastatic nasopharyngeal cancer (NPC) remains unclear. The aim of this study was to evaluate the clinical value of AAPR in patients with metastatic NPC. We retrospectively reviewed 209 metastatic NPC patients treated with cisplatin-based regimens. Survival data were calculated using the Kaplan-Meier method and were compared using the log-rank test. Univariate and multivariate survival analyses were conducted using the Cox proportional hazards regression methodology. The optimal cutoff level of AAPR for assessing overall survival (OS) was 0.447, which was determined by R software. An AAPR less than 0.447 was significantly associated with a higher lactate dehydrogenase (LDH) level (273 vs. 185 U/L, P = 0.004), a higher EBV DNA viral load (5.59×105 vs. 3.49×104 copies/ml, P = 0.001), and more liver and bone metastases (P = 0.005 and P = 0.001, respectively). Additionally, patients with an AAPR < 0.447 had a shorter overall survival and progression-free survival (hazard ratio: 3.269, 95% confidence interval: 1.710-6.248; HR: 2.295, 95% confidence interval: 1.217-4.331, respectively) than those with an AAPR ≥ 0.447. Our study suggested that the AAPR might be a novel prognostic factor in metastatic NPC patients treated with cisplatin-based regimens. However, a prospective study to validate its prognostic value is needed, and the mechanisms underlying the low AAPR and poor survival in metastatic NPC need to be further investigated. PMID:28382143

  20. Efficacy of triple antiemetic therapy (palonosetron, dexamethasone, aprepitant) for chemotherapy-induced nausea and vomiting in patients receiving carboplatin-based, moderately emetogenic chemotherapy.

    PubMed

    Miya, Toshimichi; Kobayashi, Kunihiko; Hino, Mitsunori; Ando, Masahiro; Takeuchi, Susumu; Seike, Masahiro; Kubota, Kaoru; Gemma, Akihiko

    2016-01-01

    Chemotherapy-induced nausea and vomiting (CINV) is a major adverse toxicity of cancer chemotherapy. Recommended treatments for prevention of CINV vary among published guidelines, and optimal care for CINV caused by moderately emetogenic chemotherapy has not been established. This study assessed the efficacy and safety of triple antiemetic therapy comprising palonosetron, dexamethasone and aprepitant for carboplatin-based chemotherapy. Chemotherapy-naïve patients with lung cancer scheduled for a first course of a carboplatin-containing regimen formed the study cohort. Patients were pretreated with antiemetic therapy comprising palonosetron (0.75 mg, i.v.) and dexamethasone (9.9 mg, i.v.) on day 1, and aprepitant (125 mg, p.o.) on day 1 followed by 80 mg on days 2 and 3. Primary endpoint was the proportion of patients who did not experience vomiting and did not require rescue medication [complete response (CR)] in the acute phase (0-24 h), late phase (24-168 h) and overall. Secondary endpoint was the proportion of patients who experienced no vomiting episodes and no more than mild nausea without the need for rescue medication [complete control (CC)]. Prevalence of a CR during the acute phase, delayed phase, and overall was 100, 91.9 and 91.9%, whereas that of CC was 100, 84.4 and 84.4%, respectively. The most common adverse event was mild constipation; severe adverse events related to antiemetic treatment were not observed. Triple antiemetic therapy comprising palonosetron, dexamethasone and aprepitant shows excellent effects in the prevention of CINV in patients receiving a carboplatin-containing regimen.

  1. Incidence of chemotherapy-induced nausea and vomiting with moderately emetogenic chemotherapy: ADVICE (Actual Data of Vomiting Incidence by Chemotherapy Evaluation) study.

    PubMed

    Escobar, Yolanda; Cajaraville, Gerardo; Virizuela, Juan Antonio; Álvarez, Rosa; Muñoz, Andrés; Olariaga, Olatz; Tamés, María José; Muros, Begoña; Lecumberri, María Jose; Feliu, Jaime; Martínez, Purificación; Adansa, Juan Carlos; Martínez, María José; López, Rafael; Blasco, Ana; Gascón, Pere; Calvo, Virginia; Luna, Pablo; Montalar, Joaquín; Del Barrio, Patricia; Tornamira, María Victoria

    2015-09-01

    This study aims to determine the incidence of nausea and vomiting (CINV) after moderately emetogenic chemotherapy (MEC), under medical practice conditions and the accuracy with which physicians perceive CINV. Chemotherapy-naive patients receiving MEC between April 2012 and May 2013 were included. Patients completed a diary of the intensity of nausea and number of vomiting episodes. Complete response and complete protection were assessed as secondary endpoints. Of 261 patients included, 240 were evaluated. Median age was 64 years, 44.2 % were female and 11.2 % were aged less than 50 years; 95.3 % of patients received a combination of 5-hydroxytryptamine 3 (5-HT3) antagonist + corticosteroid as antiemetic treatment. Vomiting within 5 days of chemotherapy administration occurred in 20.8 %, nausea in 42 % and significant nausea in 23.8 % of patients. An increase in the percentage of patients with significant nausea (from 9.4 to 21.7 %) and vomiting (from 9.2 to 16.5 %) was observed from the acute to the delayed phase. Complete response was 84.2 % in the acute phase, 77 % in the late phase and 68.9 % in overall period. Complete protection was 79.5 % in the acute phase, 68.8 % in the late phase and 62.4 % throughout the study period. Physicians estimated prophylaxis would be effective for 75 % of patients receiving MEC, compared with 54.1 % obtained from patients' diary. Despite receiving prophylactic treatment, 31 % of patients did not achieve a complete response and 38 % complete protection. In general, nausea was worse controlled than vomiting. The results also showed the late phase was worse controlled than the acute phase in all variables. Healthcare providers overestimated the effectiveness of antiemetic prophylaxis.

  2. Prognostic Value of Neutrophil-Related Factors in Locally Advanced Cervical Squamous Cell Carcinoma Patients Treated with Cisplatin-Based Concurrent Chemoradiotherapy.

    PubMed

    Wang, Yan-Yang; Bai, Zhou-Lan; He, Jian-Li; Yang, Yan; Zhao, Ren; Hai, Ping; Zhe, Hong

    2016-01-01

    The aim of this study was to explore the relationship between neutrophil-related factors, including neutrophil-lymphocyte ratio (NLR) and the responses of neutrophil to granulocyte colony-stimulating factors (RNG), and the prognosis of patients with locally advanced cervical squamous cell carcinoma (LACSCC) undergoing cisplatin-based concurrent chemoradiotherapy (CCCRT). A total of sixty LACSCC patients were enrolled in this study. We analyzed the association of NLR or RNG with clinicopathologic characteristics of these patients. The prognostic factors were evaluated by univariate and multivariate survival analysis. The optimal cut-off value of the NLR was determined to be 2.0 for the overall survival (OS). A higher level of the NLR was associated with younger age (P = 0.017) and higher baseline platelet count (P = 0.040). NLR was identified to be the only independent prognostic factor for OS by multivariate analysis (P = 0.037). The median RNG was 3.01, with a range of 1.19-16.84. RNG level was significantly associated with lymph node metastasis of these patients (P = 0.023). And higher RNG was identified as being a closely independent poor prognostic factor for OS (P = 0.055). This study showed that NLR and RNG may be used as potential biomarkers for survival prediction in patients with LACSCC receiving CCCRT.

  3. Conventional Cisplatin-Based Combination Chemotherapy Is Effective in the Treatment of Metastatic Spermatocytic Seminoma with Extensive Rhabdomyosarcomatous Transformation

    PubMed Central

    Jeong, Yumun; Cheon, Jaekyung; Kim, Tae-Oh; Lim, Doo-Ho; Lee, Sunpyo; Cho, Young-Mi; Hong, Jun Hyuk; Lee, Jae Lyun

    2015-01-01

    A 52-year-old man was presented with a huge left testicular mass and palpable cervical lymphadenopathy with retroperitoneal lymph node enlargement on an abdominal computed tomography. A left radical orchiectomy and an ultrasound-guided neck node biopsy were performed. A pathological examination revealed spermatocytic seminoma with extensive rhabdomyosarcomatous transformation, a condition known to be highly resistant to platinum-based chemotherapy. The patient received four cycles of etoposide, ifosfamide and cisplatin (VIP) chemotherapy. A repeat computed tomography revealed a substantial regression consistent with a partial response. Retroperitoneal lymph node dissection was attempted, which revealed rhabdomyosarcoma; however, complete microscopic resection was not achieved. After surgery, the residual abdominal lymph node progressed and salvage paclitaxel, ifosfamide and cisplatin (TIP) chemotherapy was employed, which again achieved a partial response. Here, we present a first case report of a spermatocytic seminoma with extensive rhabdomyosarcomatous transformation and multiple metastatic lymphadenopathies that showed a favorable response to platinum-based systemic chemotherapy. PMID:25381827

  4. Conventional Cisplatin-Based Combination Chemotherapy Is Effective in the Treatment of Metastatic Spermatocytic Seminoma with Extensive Rhabdomyosarcomatous Transformation.

    PubMed

    Jeong, Yumun; Cheon, Jaekyung; Kim, Tae-Oh; Lim, Doo-Ho; Lee, Sunpyo; Cho, Young-Mi; Hong, Jun Hyuk; Lee, Jae Lyun

    2015-10-01

    A 52-year-old man was presented with a huge left testicular mass and palpable cervical lymphadenopathy with retroperitoneal lymph node enlargement on an abdominal computed tomography. A left radical orchiectomy and an ultrasound-guided neck node biopsy were performed. A pathological examination revealed spermatocytic seminoma with extensive rhabdomyosarcomatous transformation, a condition known to be highly resistant to platinum-based chemotherapy. The patient received four cycles of etoposide, ifosfamide and cisplatin (VIP) chemotherapy. A repeat computed tomography revealed a substantial regression consistent with a partial response. Retroperitoneal lymph node dissection was attempted, which revealed rhabdomyosarcoma; however, complete microscopic resection was not achieved. After surgery, the residual abdominal lymph node progressed and salvage paclitaxel, ifosfamide and cisplatin (TIP) chemotherapy was employed, which again achieved a partial response. Here, we present a first case report of a spermatocytic seminoma with extensive rhabdomyosarcomatous transformation and multiple metastatic lymphadenopathies that showed a favorable response to platinum-based systemic chemotherapy.

  5. Reversal of multidrug resistance in human lung cancer cells by delivery of 3-octadecylcarbamoylacrylic acid–cisplatin-based liposomes

    PubMed Central

    Song, Juan; Ren, Weifang; Xu, Tingting; Zhang, Yi; Guo, Hongyu; Zhu, Shanshan; Yang, Li

    2017-01-01

    Liposome-based drug delivery system would be an innovative and promising candidate to circumvent multidrug resistance (MDR) of cisplatin (CDDP). However, the reversal efficacy of liposomal CDDP was severely impaired by weak cellular uptake and insufficient intracellular drug release. In this study, 3-octadecylcarbamoylacrylic acid–CDDP nanocomplex (OMI–CDDP–N)-based liposomes (OCP-L) with high cellular uptake and sufficient intracellular drug release were designed to circumvent MDR of lung cancer. OMI–CDDP–N was synthesized through a pH-sensitive monocarboxylato and an O→Pt coordinate bond, which is more efficient than CDDP. Also, OCP-L incorporated with OMI–CDDP–N could induce effective cellular uptake, enhanced nuclear distribution, and optimal cellular uptake kinetics. In particular, OCP-L presented superior effects on enhancing cell apoptosis and in vitro cytotoxicity in CDDP-resistant human lung cancer (A549/CDDP) cells. The mechanisms of MDR reversal in A549/CDDP cells by OCP-L could attribute to organic cation transporter 2 restoration, ATPase copper-transporting beta polypeptide suppression, hypoxia-inducible factor 1 α-subunit depletion, and phosphatidylinositol 3-kinase/Akt pathway inhibition. These results demonstrated that OCP-L may provide an effective delivery of CDDP to resistant cells to circumvent MDR and enhance the therapeutic index of the chemotherapy. PMID:28255230

  6. Empirical force field for cisplatin based on quantum dynamics data: case study of new parameterization scheme for coordination compounds.

    PubMed

    Yesylevskyy, S; Cardey, Bruno; Kraszewski, S; Foley, Sarah; Enescu, Mironel; da Silva, Antônio M; Dos Santos, Hélio F; Ramseyer, Christophe

    2015-10-01

    Parameterization of molecular complexes containing a metallic compound, such as cisplatin, is challenging due to the unconventional coordination nature of the bonds which involve platinum atoms. In this work, we develop a new methodology of parameterization for such compounds based on quantum dynamics (QD) calculations. We show that the coordination bonds and angles are more flexible than in normal covalent compounds. The influence of explicit solvent is also shown to be crucial to determine the flexibility of cisplatin in quantum dynamics simulations. Two empirical topologies of cisplatin were produced by fitting its atomic fluctuations against QD in vacuum and QD with explicit first solvation shell of water molecules respectively. A third topology built in a standard way from the static optimized structure was used for comparison. The later one leads to an excessively rigid molecule and exhibits much smaller fluctuations of the bonds and angles than QD reveals. It is shown that accounting for the high flexibility of cisplatin molecule is needed for adequate description of its first hydration shell. MD simulations with flexible QD-based topology also reveal a significant decrease of the barrier of passive diffusion of cisplatin accross the model lipid bilayer. These results confirm that flexibility of organometallic compounds is an important feature to be considered in classical molecular dynamics topologies. Proposed methodology based on QD simulations provides a systematic way of building such topologies.

  7. Comprehensive Audiometric Analysis of Hearing Impairment and Tinnitus After Cisplatin-Based Chemotherapy in Survivors of Adult-Onset Cancer

    PubMed Central

    Frisina, Robert D.; Wheeler, Heather E.; Fossa, Sophie D.; Kerns, Sarah L.; Fung, Chunkit; Sesso, Howard D.; Monahan, Patrick O.; Feldman, Darren R.; Hamilton, Robert; Vaughn, David J.; Beard, Clair J.; Budnick, Amy; Johnson, Eileen M.; Ardeshir-Rouhani-Fard, Shirin; Lipshultz, Steven E.; Dolan, M. Eileen; Travis, Lois B.

    2016-01-01

    Purpose Cisplatin is widely used but highly ototoxic. Effects of cumulative cisplatin dose on hearing loss have not been comprehensively evaluated in survivors of adult-onset cancer. Patients and Methods Comprehensive audiological measures were conducted on 488 North American male germ cell tumor (GCT) survivors in relation to cumulative cisplatin dose, including audiograms (0.25 to 12 kHz), tests of middle ear function, and tinnitus. American Speech-Language-Hearing Association criteria defined hearing loss severity. The geometric mean of hearing thresholds (0.25 to 12 kHz) summarized overall hearing status consistent with audiometric guidelines. Patients were sorted into quartiles of hearing thresholds of age- and sex-matched controls. Results Increasing cumulative cisplatin dose (median, 400 mg/m2; range, 200 to 800 mg/m2) was significantly related to hearing loss at 4, 6, 8, 10, and 12 kHz (P trends, .021 to < .001): every 100 mg/m2 increase resulted in a 3.2-dB impairment in age-adjusted overall hearing threshold (4 to 12 kHz; P < .001). Cumulative cisplatin doses > 300 mg/m2 were associated with greater American Speech-Language-Hearing Association–defined hearing loss severity (odds ratio, 1.59; P = .0066) and worse normative-matched quartiles (odds ratio, 1.33; P = .093) compared with smaller doses. Almost one in five (18%) patients had severe to profound hearing loss. Tinnitus (40% patients) was significantly correlated with reduced hearing at each frequency (P < .001). Noise-induced damage (10% patients) was unaffected by cisplatin dose (P = .59). Hypertension was significantly related (P = .0066) to overall hearing threshold (4 to 12 kHz) in age- and cisplatin dose–adjusted analyses. Middle ear deficits occurred in 22.3% of patients but, as expected, were not related to cytotoxic drug dosage. Conclusion Follow-up of adult-onset cancer survivors given cisplatin should include routine inquiry for hearing status and tinnitus, referral to audiologists

  8. The effects of miR-1207-5p expression in peripheral blood on cisplatin-based chemosensitivity of primary gallbladder carcinoma

    PubMed Central

    Shen, Er-Dong; Liu, Bo; Yu, Xin-Shuang; Xiang, Zhen-Fei; Huang, Hui-Yun

    2016-01-01

    in the NC and non-T groups, whereas the cell survival rates in the inhibitor group were significantly lower than the rates in the NC and non-T groups (all P<0.05). The concentration and action time of cisplatin were negatively associated with the cell survival rate in each group (all P<0.05). Conclusion Cisplatin-based chemosensitivity of PGBC increased as expression of miR-1207-5p in peripheral blood declined. Thus, miR-1207-5p appears to be a promising and novel chemosensitizer for the treatment of PGBC. PMID:27382301

  9. Reappraisal of short-term low-volume hydration in cisplatin-based chemotherapy: results of a prospective feasibility study in advanced lung cancer in the Okayama Lung Cancer Study Group Trial 1002.

    PubMed

    Hotta, Katsuyuki; Takigawa, Nagio; Hisamoto-Sato, Akiko; Ichihara, Eiki; Kudo, Kenichiro; Uchida, Koji; Yanase-Nakamura, Kayo; Tanaka, Hisaaki; Kato, Yuka; Tabata, Masahiro; Tanimoto, Mitsune; Kiura, Katsuyuki

    2013-11-01

    Cisplatin can induce severe renal toxicity. However, the degree and pattern of hydration that is most efficient at preventing it have scarcely been formally evaluated. We here performed a prospective feasibility study of cisplatin-based chemotherapy with short-term low-volume hydration in advanced lung cancer. Chemo-naïve patients with advanced lung cancer and reserving renal function who were suitable for cisplatin use (≥60 mg/m(2) on Day 1) were eligible for this study. Two-and-a-half-liter hydration within ∼4.5 h was investigated. The primary end point was the proportion of patients who underwent cisplatin-based chemotherapy without any Grade 2 or more renal toxicity in the first cycle. A total of 46 patients were registered, all of whom were evaluable for renal toxicity. The median baseline creatinine score was 0.70 mg/dl and the median cisplatin dose on Day 1 was 80 mg/m(2). In the first cycle, none of the patients developed Grade 2 or more creatinine toxicity, which met the primary endpoint. Four patients (9%) had Grade 1 toxicity, with a median worst creatinine score of 1.19 mg/dl, but it disappeared rapidly. Creatinine toxicity was influenced by several clinical factors, including the performance status. Ten patients (22%) needed extra hydration during the first cycle, mainly due to gastrointestinal toxicity. However, all 10 were able to undergo further cycles of treatment. Thirty-two (86%) of the 37 patients who were assumed to be able to undergo further treatment at our institute received it in an outpatient setting. This study demonstrated prospectively the feasibility of short-term low-volume hydration.

  10. Chemotherapy-induced nausea and vomiting and antiemetic prophylaxis with palonosetron versus other 5-HT3 receptor antagonists in patients with cancer treated with low emetogenic chemotherapy in a hospital outpatient setting in the United States.

    PubMed

    Schwartzberg, Lee; Morrow, Gary; Balu, Sanjeev; Craver, Chris; Gayle, Julie; Cox, David

    2011-08-01

    The incidence of overall (acute and delayed) chemotherapy-induced nausea and vomiting (CINV) events among patients treated with single- and multi-day low emetogenic chemotherapy (LEC) is not well established. We studied a cohort of patients receiving LEC and antiemetic prophylaxis with palonosetron (Group 1) versus other 5-HT(3) receptor antagonists (5-HT(3)-RAs) (Group 2), to determine the overall rate of CINV and the proportion of patients experiencing delayed CINV (days 2-7 of a CT cycle) in a hospital outpatient setting. Patients aged ≥18 years with cancer diagnosis initiating single-day and multi-day LEC for the first time between 4/1/2007 and 3/31/2009 were identified from the Premier Perspective database. CINV events (ICD-9-CM codes for nausea, vomiting, or volume depletion or CINV-related rescue medications) were assessed descriptively. A generalized linear multivariate regression model was developed, estimating the overall CINV event rate among Group 1 and 2 patients in the follow-up period (first of eight chemotherapy [CT] cycles or 6 months). In the follow-up period, out of a total of 10,137 overall CINV events (single-day and multi-day LEC), 8783 events (86.6%) were identified in single-day LEC treated patients. Within single-day LEC treated events, in the first cycle, of 3184 events, 2996 (94.1%) events were delayed. Average number of delayed events per patient remained consistent throughout the eight cycles (3.1 [1st cycle] vs. 2.9 [8th cycle]; P = 0.842]). Among 2439 patients on antiemetic prophylaxis with a 5-HT(3)-RA, 10.1% (n = 247) initiated palonosetron. Regression analysis indicated that Group 1 patients (versus Group 2) had a 15.2% reduction in CINV event rate per CT cycle; P = 0.0403. Study limitations include potential lack of generalizability, absence of data on certain confounders including alcohol consumption and prior history of motion sickness, potential underestimation of incidence of uncontrolled CINV, and inability to

  11. Single-dose fosaprepitant for the prevention of chemotherapy-induced nausea and vomiting associated with moderately emetogenic chemotherapy: results of a randomized, double-blind phase III trial†

    PubMed Central

    Weinstein, C.; Jordan, K.; Green, S. A.; Camacho, E.; Khanani, S.; Beckford-Brathwaite, E.; Vallejos, W.; Liang, L. W.; Noga, S. J.; Rapoport, B. L.

    2016-01-01

    Background To establish the role of antiemetic therapy with neurokinin-1 (NK1) receptor antagonists (RAs) in nonanthracycline and cyclophosphamide (AC)-based moderately emetogenic chemotherapy (MEC) regimens, this study evaluated single-dose intravenous (i.v.) fosaprepitant for the prevention of chemotherapy-induced nausea and vomiting (CINV) associated with non-AC MEC. Patients and methods In this international, phase III, double-blind trial, adult cancer subjects scheduled to receive ≥1 non-AC MEC on day 1 were randomized to a regimen comprising single-dose i.v. fosaprepitant 150 mg or placebo along with ondansetron and dexamethasone on day 1; control regimen recipients received ondansetron on days 2 and 3. Primary end points were the proportion of subjects achieving a complete response (CR; no vomiting and no use of rescue medication) in the delayed phase (25–120 h after MEC initiation) and safety. Secondary end points included CR in the overall and acute phases (0–120 and 0–24 h after MEC initiation, respectively) and no vomiting in the overall phase. Nausea and the Functional Living Index-Emesis were assessed as exploratory end points. Results The fosaprepitant regimen improved CR significantly in the delayed (78.9% versus 68.5%; P < 0.001) and overall (77.1% versus 66.9%; P < 0.001) phases, but not in the acute phase (93.2% versus 91.0%; P = 0.184), versus control. In the overall phase, the proportion of subjects with no vomiting (82.7% versus 72.9%; P < 0.001) and no significant nausea (83.2% versus 77.9%; P = 0.030) was also significantly improved with the fosaprepitant regimen. The fosaprepitant regimen was generally well tolerated. Conclusion Single-dose fosaprepitant added to a 5-HT3 RA and dexamethasone was well tolerated and demonstrated superior control of CINV (primary end point achieved) associated with non-AC MEC. This is the first study to evaluate NK1 RA therapy as an i.v. formulation in a well-defined non-AC MEC population. Clinical

  12. In Silico Oncology: Quantification of the In Vivo Antitumor Efficacy of Cisplatin-Based Doublet Therapy in Non-Small Cell Lung Cancer (NSCLC) through a Multiscale Mechanistic Model

    PubMed Central

    Kolokotroni, Eleni; Dionysiou, Dimitra; Veith, Christian; Kim, Yoo-Jin; Franz, Astrid; Grgic, Aleksandar; Bohle, Rainer M.; Stamatakos, Georgios

    2016-01-01

    The 5-year survival of non-small cell lung cancer patients can be as low as 1% in advanced stages. For patients with resectable disease, the successful choice of preoperative chemotherapy is critical to eliminate micrometastasis and improve operability. In silico experimentations can suggest the optimal treatment protocol for each patient based on their own multiscale data. A determinant for reliable predictions is the a priori estimation of the drugs’ cytotoxic efficacy on cancer cells for a given treatment. In the present work a mechanistic model of cancer response to treatment is applied for the estimation of a plausible value range of the cell killing efficacy of various cisplatin-based doublet regimens. Among others, the model incorporates the cancer related mechanism of uncontrolled proliferation, population heterogeneity, hypoxia and treatment resistance. The methodology is based on the provision of tumor volumetric data at two time points, before and after or during treatment. It takes into account the effect of tumor microenvironment and cell repopulation on treatment outcome. A thorough sensitivity analysis based on one-factor-at-a-time and latin hypercube sampling/partial rank correlation coefficient approaches has established the volume growth rate and the growth fraction at diagnosis as key features for more accurate estimates. The methodology is applied on the retrospective data of thirteen patients with non-small cell lung cancer who received cisplatin in combination with gemcitabine, vinorelbine or docetaxel in the neoadjuvant context. The selection of model input values has been guided by a comprehensive literature survey on cancer-specific proliferation kinetics. The latin hypercube sampling has been recruited to compensate for patient-specific uncertainties. Concluding, the present work provides a quantitative framework for the estimation of the in-vivo cell-killing ability of various chemotherapies. Correlation studies of such estimates with

  13. Risk Factors of Ototoxicity After Cisplatin-Based Chemo-Irradiation in Patients With Locally Advanced Head-and-Neck Cancer: A Multivariate Analysis

    SciTech Connect

    Zuur, Charlotte L. . E-mail: cl.zuur@vumc.nl; Simis, Yvonne J.; Lansdaal, Pauline E.; Hart, Augustinus A.; Rasch, Coen R.; Schornagel, Jan H.; Dreschler, Wouter A.; Balm, Alfons J.

    2007-08-01

    Purpose: Cisplatin chemo-irradiation is increasingly used in locally advanced squamous cell carcinoma of the head and neck. The objective of this study is to determine risk factors of ototoxicity due to intra-arterial high-dose cisplatin chemoradiation. Methods and Materials: A prospective analysis of hearing thresholds at low and (ultra) high frequencies obtained before, during, and after treatment in 146 patients. Treatment consisted of intra-arterial infusion of high-dose cisplatin (150 mg/m{sup 2}, four courses) with sodium thiosulfate rescue and concurrent radiation therapy (70 Gy). Patient and chemoradiation variables were studied in a multivariate analysis. Results: After treatment, 23% of the ears were under consideration for hearing aids because of therapy. Twenty-two percent of the patients developed an increase in air-bone gap >10 dB during or after therapy. In the multivariate explanatory analysis, cumulative dose of cisplatin and radiation therapy, and young age displayed a causal relationship with increased sensorineural hearing loss during and after therapy (p < 0.001). In the multivariate prediction analysis, pretreatment hearing level of the concerning ear was identified as an independent predictive factor for hearing capability after therapy (p < 0.0001). Conclusions: Both cisplatin and radiation therapy were proven to induce sensorineural hearing loss, in this study with short-term follow-up. Of all patient and treatment variables studied, the patients pretreatment hearing level appeared to be the main predictive factor for hearing capability after high-dose intra-arterial cisplatin chemoradiation.

  14. Randomized Clinical Trial of Weekly vs. Triweekly Cisplatin-Based Chemotherapy Concurrent With Radiotherapy in the Treatment of Locally Advanced Cervical Cancer

    SciTech Connect

    Ryu, Sang-Young; Lee, Won-Moo; Kim, Kidong; Park, Sang-Il; Kim, Beob-Jong; Kim, Moon-Hong; Choi, Seok-Cheol; Cho, Chul-Koo; Nam, Byung-Ho; Lee, Eui-Don

    2011-11-15

    Purpose: To compare compliance, toxicity, and outcome of weekly and triweekly cisplatin administration concurrent with radiotherapy in locally advanced cervical cancer. Methods and Materials: In this open-label, randomized trial, 104 patients with histologically proven Stage IIB-IVA cervical cancer were randomly assigned by a computer-generated procedure to weekly (weekly cisplatin 40 mg/m{sup 2}, six cycles) and triweekly (cisplatin 75 mg/m{sup 2} every 3 weeks, three cycles) chemotherapy arms during concurrent radiotherapy. The difference of compliance and the toxicity profiles between the two arms were investigated, and the overall survival rate was analyzed after 5 years. Results: All patients tolerated both treatments very well, with a high completion rate of scheduled chemotherapy cycles. There was no statistically significant difference in compliance between the two arms (86.3% in the weekly arm, 92.5% in the triweekly arm, p > 0.05). Grade 3-4 neutropenia was more frequent in the weekly arm (39.2%) than in the triweekly arm (22.6%) (p = 0.03). The overall 5-year survival rate was significantly higher in the triweekly arm (88.7%) than in the weekly arm (66.5%) (hazard ratio 0.375; 95% confidence interval 0.154-0.914; p = 0.03). Conclusions: Triweekly cisplatin 75-mg/m{sup 2} chemotherapy concurrent with radiotherapy is more effective and feasible than the conventional weekly cisplatin 40-mg/m{sup 2} regimen and may be a strong candidate for the optimal cisplatin dose and dosing schedule in the treatment of locally advanced cervical cancer.

  15. Poor chemotherapy-induced nausea and vomiting control in children receiving intermediate or high dose methotrexate.

    PubMed

    Vol, Helen; Flank, Jacqueline; Lavoratore, Sara R; Nathan, Paul C; Taylor, Tracey; Zelunka, Elyse; Maloney, Anne Marie; Lee Dupuis, L

    2016-03-01

    Chemotherapy emetogenicity is the most important known determinant of chemotherapy-induced vomiting (CIV) in children. However, direct evidence regarding the emetogenic potential of chemotherapeutic agents in children is limited. This study describes the prevalence of complete control of acute and delayed phase chemotherapy-induced nausea and vomiting (CINV) in children receiving methotrexate. The prevalence of anticipatory CINV is described, and risk factors for CINV are explored. English-speaking children (4 to 18 years) receiving intermediate-dose (ID-MTX: >1 to <12 g/m(2)/dose) or high-dose methotrexate (HD-MTX: ≥12 g/m(2)/dose) participated in this prospective study. Emetic episodes, nausea severity, and antiemetic administration were documented for 24 h from the start of the methotrexate infusion (acute phase) and for up to a further 168 h (delayed phase). CINV prophylaxis was provided at the discretion of the treating physician. Anticipatory CINV was assessed in the 24 h preceding chemotherapy. Complete CINV control was defined as no emetic episodes and no nausea. Thirty children (mean age, 11.8 ± 4 years; ID-MTX, 20; HD-MTX, 10) completed the study. CINV prophylaxis included the following: ondansetron/granisetron plus dexamethasone or nabilone. Few patients experienced complete CINV control (ID-MTX: acute phase 20%, delayed phase 5%; HD-MTX: acute phase 0%, delayed phase 30%). Complete emesis control was higher (ID-MTX: acute phase 70%, delayed phase 50%; HD-MTX: acute phase 70%, delayed phase 60%). Anticipatory CINV was reported by 6/28 patients (21%). Patient age, sex, and history of motion sickness were not significant predictors of CINV. The poor complete CINV control rate in children receiving methotrexate confirms the classification of HD-MTX as highly emetogenic chemotherapy (HEC) and suggests that ID-MTX be reclassified as HEC.

  16. Netupitant/Palonosetron: A Review in the Prevention of Chemotherapy-Induced Nausea and Vomiting.

    PubMed

    Keating, Gillian M

    2015-12-01

    An oral fixed combination of netupitant/palonosetron (NEPA; Akynzeo(®)) is available for use in the prevention of acute and delayed chemotherapy-induced nausea and vomiting (CINV). Netupitant is a highly selective neurokinin-1 receptor antagonist and palonosetron is a serotonin 5-HT3 receptor antagonist with a distinct pharmacological profile. Complete response rates during the delayed, acute and overall phases were significantly higher with single-dose netupitant 300 mg plus palonosetron 0.5 mg than with single-dose palonosetron 0.5 mg in cycle 1 of cisplatin-based highly emetogenic chemotherapy (HEC) in a phase II trial and with single-dose netupitant/palonosetron 300/0.5 mg than with single-dose palonosetron 0.5 mg in cycle 1 of anthracycline-cyclophosphamide (AC) moderately emetogenic chemotherapy (MEC) in a phase III trial; the greater efficacy of netupitant/palonosetron was maintained over repeated cycles of AC MEC in the phase III trial. In another phase III trial, netupitant/palonosetron 300/0.5 mg was effective over repeated cycles of non-AC MEC or HEC. Netupitant/palonosetron was well tolerated, with no cardiac safety concerns. The convenience of administering netupitant/palonosetron as a single dose in a fixed combination has the potential to improve adherence to CINV prevention guidelines. In conclusion, netupitant/palonosetron is an important option to consider in the prevention of acute and delayed CINV in patients receiving MEC or HEC.

  17. Retrospective study of efficacy and toxicity on patients older than 70 years within a randomized clinical trial of two cisplatin-based combinations in patients with small-cell lung cancer.

    PubMed

    Safont, María José; Artal-Cortes, Angel; Sirera, Rafael; Gómez-Codina, José; González-Larriba, José Luis; Barneto, Isidoro; Carrato, Alfredo; Isla, Dolores; Rosell, Rafael; Camps, Carlos

    2009-01-01

    A retrospective analysis based on the Spanish Lung Cancer Group (SLCG) clinical trial of high-dose epirubicin/cisplatin in patients with small-cell lung cancer (SCLC) was performed. Patients younger than 70 years vs. older than 70 years old were analyzed to evaluate the influence of age on response to treatment, toxicity, time to progression (TTP) and overall survival (OS) of the chemotherapy schedule. Three hundred and thirty eight patients <70 years and sixty-four >70 years, were analyzed. Objective responses were similar in both groups. In patients less than 70 years higher TTP (36 weeks vs. 32 weeks) and OS (47 weeks vs. 42 weeks) were seen, attributable to the improved results observed in the subgroup of patients with limited disease (LD). No significant differences were observed when toxicity profile of both groups was compared, except for a higher rate of febrile neutropenia observed in the elderly group with extensive disease (4.6% vs. 8.8%, p=0.01). In the subgroup of patients with LD, elderly patients received less total cisplatin dose (401 vs. 508 mg/m(2), p=0.01) although less treatment delays were reported (10 days vs. 15 days, p=0.05). Age was likely to be a negative prognostic factor for OS of elderly patients with LD. It also seemed to be related to a greater dose reduction, which may explain that toxic episodes and delays occurred more frequently in the younger patients receiving the full scheduled dose. However, the definitive reason to explain this could not be established due to the characteristics of our analysis.

  18. Extended high-frequency audiometry (9,000-20,000 Hz). Usefulness in audiological diagnosis.

    PubMed

    Rodríguez Valiente, Antonio; Roldán Fidalgo, Amaya; Villarreal, Ithzel M; García Berrocal, José R

    2016-01-01

    Early detection and appropriate treatment of hearing loss are essential to minimise the consequences of hearing loss. In addition to conventional audiometry (125-8,000 Hz), extended high-frequency audiometry (9,000-20,000 Hz) is available. This type of audiometry may be useful in early diagnosis of hearing loss in certain conditions, such as the ototoxic effect of cisplatin-based treatment, noise exposure or oral misunderstanding, especially in noisy environments. Eleven examples are shown in which extended high-frequency audiometry has been useful in early detection of hearing loss, despite the subject having a normal conventional audiometry. The goal of the present paper was to highlight the importance of the extended high-frequency audiometry examination for it to become a standard tool in routine audiological examinations.

  19. Postoperative Chemotherapy Followed by Conformal Concomitant Chemoradiotherapy in High-Risk Gastric Cancer

    SciTech Connect

    Quero, Laurent; Bouchbika, Zineb; Kouto, Honorine; Baruch-Hennequin, Valerie; Gornet, Jean-Marc; Munoz, Nicolas; Cojean-Zelek, Isabelle; Houdart, Remi; Panis, Yves; Valleur, Patrice; Aparicio, Thomas; Maylin, Claude; Hennequin, Christophe

    2012-06-01

    Purpose: To analyze the efficacy, toxicity, and pattern of relapse after adjuvant cisplatin-based chemotherapy followed by three-dimensional irradiation and concomitant LV5FU2 chemotherapy (high-dose leucovorin and 5-fluorouracil bolus plus continuous infusion) in the treatment of completely resected high-risk gastric cancer. Methods and Materials: This was a retrospective analysis of 52 patients with high-risk gastric cancer initially treated by total/partial gastrectomy and lymphadenectomy between January 2002 and June 2007. Median age was 54 years (range, 36-75 years). Postoperative treatment consisted of 5-fluorouracil and cisplatin chemotherapy. Adjuvant chemotherapy was followed by three-dimensional conformal radiotherapy in the tumor bed and regional lymph nodes at 4500 cGy/25 fractions in association with concomitant chemotherapy. Concomitant chemotherapy consisted of a 2-h infusion of leucovorin (200 mg/m Superscript-Two ) followed by a bolus of 5-fluorouracil (400 mg/m Superscript-Two ) and then a 44-h continuous infusion of 5-fluorouracil (2400-3600 mg/m Superscript-Two ) given every 14 days, for three cycles (LV5FU2 protocol). Results: Five-year overall and disease-free survival were 50% and 48%, respectively. Distant metastases and peritoneal spread were the most frequent sites of relapse (37% each). After multivariate analysis, only pathologic nodal status was significantly associated with disease-free and overall survival. Acute toxicities were essentially gastrointestinal and hematologic. One myocardial infarction and one pulmonary embolism were also reported. Eighteen patients had a radiotherapy program interruption because of acute toxicity. All patients but 2 have completed radiotherapy. Conclusion: Postoperative cisplatin-based chemotherapy followed by conformal radiotherapy in association with concurrent 5-fluorouracil seemed to be feasible and resulted in successful locoregional control.

  20. A retrospective review of antiemetic use for chemotherapy-induced nausea and vomiting in pediatric oncology patients at a tertiary care center.

    PubMed

    Aseeri, Mohammed; Mukhtar, Amnah; Al Khansa, Sara; Elimam, Nagla; Jastaniah, Wasil

    2013-06-01

    Chemotherapy-induced nausea and vomiting are the most dreaded and distressing side effects for cancer patients undergoing chemotherapy treatment. These side effects have a significant impact on the patients' quality of life and can interfere with their ability to receive intensive chemotherapy regimens. With the recent advances in antiemetic pharmacotherapy and supportive care, the current treatments for chemotherapy-induced nausea and vomiting, when used appropriately, have become highly effective in mitigating these adverse effects. The aim of this study was to evaluate the current practice involving antiemetic treatment in newly diagnosed pediatric oncology patients at our center. This was a retrospective cohort study of newly diagnosed pediatric oncology patients who were less than 14 years of age receiving their first cycle of inpatient chemotherapy. The data abstracted included the following: age, gender, type of cancer, chemotherapy regimen, emetogenic risk and level, prescribed prophylactic antiemetic regimen, incidence of breakthrough emesis, and breakthrough antiemetic medications used. Emetogenic risk was classified based on published guidelines into low, moderate, or high emetogenic chemotherapy, and a scoring system to determine the emetogenic level of combined chemotherapy agents was followed to monitor the efficacy of the antiemetic regimens. Clinical effectiveness was assessed based on breakthrough emesis. A total of 49 patients were eligible for the study. High emetogenic chemotherapy was administered in 28/49 (57.1%) and moderate emetogenic chemotherapy was administered in 21/49 (42.9%) patients. Only 10/49 (20.4%) received appropriate antiemetic prophylaxis, whereas 39/49 (79.6%) received inadequate antiemetic prophylaxis; 14/49 (28.6%) patients experienced breakthrough emesis. Breakthrough emesis occurred in 11/28 (39.3%) patients receiving high emetogenic chemotherapy and 3/21 (14.3%) patients receiving moderate emetogenic chemotherapy. The use

  1. Review of oral fixed-dose combination netupitant and palonosetron (NEPA) for the treatment of chemotherapy-induced nausea and vomiting.

    PubMed

    Lorusso, Vito; Karthaus, Meinolf; Aapro, Matti

    2015-01-01

    Current guidelines recommend the combination of a neurokinin-1 (NK1) receptor antagonist (RA) and a 5-hydroxytryptamine-3 (5-HT3) RA, together with corticosteroids, in order to prevent chemotherapy-induced nausea and vomiting with anthracycline-cyclophosphamide and highly emetogenic chemotherapy, and it is to be considered with moderately emetogenic chemotherapy. Netupitant and palonosetron (NEPA) is a fixed-dose combination of netupitant, a novel, highly selective NK1 RA, and palonosetron, a new-generation 5-HT3 RA, targeting two major emetic pathways in a single oral capsule. In clinical trials, NEPA administered on day 1 together with dexamethasone was highly effective and well tolerated in the prevention of chemotherapy-induced nausea and vomiting in patients with solid tumors undergoing moderately emetogenic chemotherapy or highly emetogenic chemotherapy. NEPA offers maximal convenience, and as a simple guideline-based regimen, has the potential to improve adherence to guidelines.

  2. Risk factors in germ cell tumour patients with relapse or progressive disease after first-line chemotherapy: evaluation of a prognostic score for survival after high-dose chemotherapy.

    PubMed

    Sammler, C; Beyer, J; Bokemeyer, C; Hartmann, J T; Rick, O

    2008-01-01

    To retrospectively re-evaluate a published prognostic score for response to salvage treatment in patients with germ-cell tumours relapsing or progressing after cisplatin-based first-line chemotherapy. From a database of 257 germ cell tumour (GCT) patients treated with salvage high-dose chemotherapy (HDCT) we identified 176 patients (67%) with relapse or progression after first-line conventional-dose chemotherapy (CDCT). Patients were retrospectively grouped according to a published prognostic score defined by Fossa and colleagues [Fossa SD, Stenning SP, Gerl A, et al. Prognostic factors in patients progressing after cisplatin-based chemotherapy for malignant non-seminomatous germ cell tumors. Br J Cancer 1999; 80:1392-9]. Overall survival (OS) and event free survival (EFS) after HDCT were retrospectively evaluated in each prognostic group. After a median follow-up of 9 years the OS probability for all 176 patients was 38% and the EFS probability was 35%. The respective survival probability at 5 years in 100/176 (57%) good prognosis patients and 76/176 (43%) poor prognosis patients were 47% versus 28% for OS (p<0.001) and 41% versus 26% for EFS (p<0.005). Whereas survival probabilities did not differ in good prognosis patients, OS and EFS in poor prognosis patients were substantially better in the current series of patients treated with HDCT compared to the ones reported by Fossa treated with CDCT. This retrospective analysis confirms the impact of prognostic factors on the results of salvage treatment in patients with GCT and suggests a clinical benefit for patients with poor prognosis features receiving a single course of HDCT.

  3. Efficacy and safety of single-dose fosaprepitant in the prevention of chemotherapy-induced nausea and vomiting in patients receiving high-dose cisplatin: a multicentre, randomised, double-blind, placebo-controlled phase 3 trial

    PubMed Central

    Saito, H.; Yoshizawa, H.; Yoshimori, K.; Katakami, N.; Katsumata, N.; Kawahara, M.; Eguchi, K.

    2013-01-01

    Background We evaluated the efficacy and safety of single-dose fosaprepitant in combination with intravenous granisetron and dexamethasone. Patients and methods Patients receiving chemotherapy including cisplatin (≥70 mg/m2) were eligible. A total of 347 patients (21% had received cisplatin with vomiting) were enrolled in this trial to receive the fosaprepitant regimen (fosaprepitant 150 mg, intravenous, on day 1 in combination with granisetron, 40 μg/kg, intravenous, on day 1 and dexamethasone, intravenous, on days 1–3) or the control regimen (placebo plus intravenous granisetron and dexamethasone). The primary end point was the percentage of patients who had a complete response (no emesis and no rescue therapy) over the entire treatment course (0–120 h). Results The percentage of patients with a complete response was significantly higher in the fosaprepitant group than in the control group (64% versus 47%, P = 0.0015). The fosaprepitant regimen was more effective than the control regimen in both the acute (0–24 h postchemotherapy) phase (94% versus 81%, P = 0.0006) and the delayed (24–120 h postchemotherapy) phase (65% versus 49%, P = 0.0025). Conclusions Single-dose fosaprepitant used in combination with granisetron and dexamethasone was well-tolerated and effective in preventing chemotherapy-induced nausea and vomiting in patients receiving highly emetogenic cancer chemotherapy, including high-dose cisplatin. PMID:23117073

  4. Various emetogens increase the secretion of salivary amylase in rats: a potential model in emesis research.

    PubMed

    Fukui, Hideo; Miwa, Eri; Iwachido, Takako; Kitaura, Harumi; Furukawa, Hatsue

    2010-01-01

    We investigated the effects of various emetic agents: cisplatin, apomorphine, lithium chloride (LiCl), rolipram, sibutramine, and the beta(3)-adrenoceptor (AR) agonist CL316243 on salivary amylase secretion in rats. We also determined the inhibitory effect of granisetron, a 5-HT(3)-receptor antagonist, on cisplatin-induced increased salivary amylase activity and the inhibitory effect of bilateral abdominal vagotomy on increases in salivary amylase activity induced by cisplatin and LiCl. Granisetron was administered 15 min before and 1 h after cisplatin administration. Cisplatin (10 - 15 mg/kg, i.v.) increased salivary amylase activity dose-dependently and induced an acute increase from 1.5 h post-treatment with 15 mg/kg. Apomorphine (1 - 3 mg/kg, s.c.), LiCl (120 mg/kg, i.p.), rolipram (3 - 10 mg/kg, p.o.), and sibutramine (10 mg/kg, p.o.) induced significant increases in salivary amylase secretion. On the other hand, CL316243 did not stimulate salivary amylase secretion. The increased amylase activity induced by cisplatin (15 mg/kg, i.v.) was inhibited significantly by granisetron (1 or 3 mg/kg x 2, i.v.) or tended to be inhibited by bilateral abdominal vagotomy, whereas an increase in amylase activity produced by LiCl was not inhibited by abdominal visceral nerve section. These results suggest that salivary amylase activity is useful as a marker for emesis in rats, a species that does not exhibit vomiting.

  5. May glutamine addiction drive the delivery of antitumor cisplatin-based Pt(IV) prodrugs?

    PubMed

    Ravera, Mauro; Gabano, Elisabetta; Tinello, Stefano; Zanellato, Ilaria; Osella, Domenico

    2017-02-01

    A small series of Pt(IV) prodrugs containing Gln-like (Gln=glutamine) axial ligands has been designed with the aim to take advantage of the increased demand of Gln showed by some cancer cells (glutamine addiction). In complex 4 the Gln, linked through the α-carboxylic group is recognized by the Gln transporters, in particular by the solute carrier transporter SLC1A5. All compounds showed cellular accumulation, as well as antiproliferative activity, related to their lipophilicity, as already demonstrated for the majority of Pt(IV) prodrugs, that enter cells mainly by passive diffusion. On the contrary, when the Gln concentration in cell medium is near or lower to the physiological value, complex 4 acts as a Trojan horse: it enters SLC1A5-overexpressing cells, where, upon reduction, it releases the active metabolite cisplatin and the Gln-containing ligand, thus preventing any possible extrusion by the L-type amino acid transporter LAT1. This selective mechanism could decrease off-target accumulation of 4 and, consequently, Pt-associated side-effects.

  6. Epigallocatechin-3-gallate, a prototypic chemopreventative agent for protection against cisplatin-based ototoxicity

    PubMed Central

    Borse, Vikrant; Al Aameri, Raheem F H; Sheehan, Kelly; Sheth, Sandeep; Kaur, Tejbeer; Mukherjea, Debashree; Tupal, Srinivasan; Lowy, Michelle; Ghosh, Sumana; Dhukhwa, Asmita; Bhatta, Puspanjali; Rybak, Leonard P; Ramkumar, Vickram

    2017-01-01

    Cisplatin-induced ototoxicity is one of the major factors limiting cisplatin chemotherapy. Ototoxicity results from damage to outer hair cells (OHCs) and other regions of the cochlea. At the cellular level, cisplatin increases reactive oxygen species (ROS) leading to cochlear inflammation and apoptosis. Thus, ideal otoprotective drugs should target oxidative stress and inflammatory mechanisms without interfering with cisplatin's chemotherapeutic efficacy. In this study, we show that epigallocatechin-3-gallate (EGCG) is a prototypic agent exhibiting these properties of an effect otoprotective agent. Rats administered oral EGCG demonstrate reduced cisplatin-induced hearing loss, reduced loss of OHCs in the basal region of the cochlea and reduced oxidative stress and apoptotic markers. EGCG also protected against the loss of ribbon synapses associated with inner hair cells and Na+/K+ ATPase α1 in the stria vascularis and spiral ligament. In vitro studies showed that EGCG reduced cisplatin-induced ROS generation and ERK1/2 and signal transducer and activator of transcription-1 (STAT1) activity, but preserved the activity of STAT3 and Bcl-xL. The increase in STAT3/STAT1 ratio appears critical for mediating its otoprotection. EGCG did not alter cisplatin-induced apoptosis of human-derived cancer cells or cisplatin antitumor efficacy in a xenograft tumor model in mice because of its inability to rescue the downregulation of STAT3 in these cells. These data suggest that EGCG is an ideal otoprotective agent for treating cisplatin-induced hearing loss without compromising its antitumor efficacy. PMID:28703809

  7. The impact of paclitaxel or cisplatin-based chemotherapy on sympathetic skin response: a prospective study.

    PubMed

    Argyriou, A A; Koutras, A; Polychronopoulos, P; Papapetropoulos, S; Iconomou, G; Katsoulas, G; Makatsoris, T; Kalofonos, H P; Chroni, E

    2005-11-01

    The current study aimed to assess the viability of sympathetic sudomotor fibers in cancer patients treated with cisplatin or paclitaxel-based chemotherapy and to ascertain whether this method could contribute to the diagnostic sensitivity of conventional techniques. Sympathetic skin response (SSR) from the hand and sole of 23 cancer patients (nine females and 14 males, mean age 62.4 +/- 10.5 years) was recorded unilaterally before and after chemotherapy with six courses of cumulative cisplatin or paclitaxel containing regimens. Clinical and electrophysiological data were also collected and correlated with the SSR results. Twenty-three healthy subjects served as controls. SSR abnormalities were only present in patients with evidence of peripheral neuropathy assessed by conventional nerve conduction techniques. Three patients had absent SSR in the upper limb whilst six patients had absent SSR both in the upper and lower limbs. In the upper limb, the mean SSR latency was not significantly altered through time (P = 0.086). In the lower limb the mean delay from baseline to follow-up was significantly changed (P = 0.029). In patients, the mean SSR latency was significantly prolonged compared with controls in both upper limb (P = 0.001) and lower limb (P = 0.000). SSR abnormalities were strongly related to sensory conduction abnormalities as detected by conventional techniques (r = 0.39, P = 0.004). Our results showed that SSR does not seem to add to the diagnostic sensitivity of conventional techniques in chemotherapy-induced neuropathy. However, its role in the disclosure of small fibers neuropathy abnormalities is worth considering. Further studies are warranted to address this important issue.

  8. Changes in blood concentrations of trace metals in cancer patients receiving cisplatin-based chemotherapy

    PubMed Central

    Nakamura, Tsutomu; Takahashi, Minoru; Niigata, Riho; Yamashita, Kazuhiko; Kume, Manabu; Hirai, Midori; Yasui, Hiroyuki

    2016-01-01

    The administration of cisplatin (CDDP) may influence trace metal concentrations in body fluids. In order to test this hypothesis, the blood concentrations of trace metals were determined during the present study in eight Japanese esophageal and lung cancer patients receiving CDDP-based chemotherapy. The levels of manganese, iron (Fe), cobalt, copper, zinc (Zn), platinum and lead in the plasma were determined by inductively coupled plasma-mass spectrometry. In addition, the serum levels of Fe, transferrin and ferritin were evaluated. The baseline plasma concentration of Fe in patients with esophageal cancer was significantly lower than that in lung cancer patients (P=0.011), although there were no significant differences identified with respect to the plasma levels of other trace metals. The data obtained from six fasting patients without blood transfusion demonstrated that plasma concentrations of Fe increased 3.5-fold soon after CDDP treatment and returned to baseline levels ~10 days after therapy. The excessive Fe levels in the bloodstream induced changes in serum ferritin and transferrin levels. Furthermore, serum Zn levels increased 1.8-fold in the 1–3 days following CDDP treatment, and serum cystatin C levels transiently increased. These findings indicate that serum Fe and Zn levels may be useful to understanding the physiological responses in the early stages of CDDP-based chemotherapy, which may be associated with systemic inflammation and/or tissue distribution of CDDP. PMID:28105341

  9. Mitomycin-C- or Cisplatin-Based Chemoradiotherapy for Anal Canal Carcinoma: Long-Term Results

    SciTech Connect

    Olivatto, Luis O.; Cabral, Vania; Rosa, Arthur; Bezerra, Marcos; Santarem, Erick; Fassizoli, Ana; Castro, Leonaldson; Simoes, Jose Humberto; Small, Isabele A.; Ferreira, Carlos Gil

    2011-02-01

    Purpose: To evaluate the long-term efficacy of concurrent radiotherapy with mitomycin-C (MMC)-based or cisplatin (CP)-based combinations in a cohort of patients with locally advanced anal canal carcinoma. Methods and Materials: Between 1988 and 2000, 179 patients with locally advanced anal canal carcinoma were treated at the Instituto Nacional de Cancer with two cycles of chemotherapy during Weeks 1 and 5 of radiotherapy. 5-Fluorouracil (750 mg/m{sup 2} 120-hour infusion or 1,000 mg/m{sup 2} 96-hour infusion) plus CP (100 mg/m{sup 2}) on the first day of each cycle or MMC (10-15 mg/m{sup 2}) on the first day of Cycle 1 was administered concurrent with radiotherapy (total dose, 55-59.4 Gy). Of the 179 patients, 60% were included from a randomized trial initiated at the Instituto Nacional de Cancer in 1991 that compared concurrent chemoradiotherapy with MMC vs. CP. Results: The median follow-up for the whole chemoradiotherapy group was 83 months. The median patient age was 58 years, 57% had Stage T3-T4 tumors, and 35% had N-positive disease. The 5-year cumulative colostomy rate was not significantly different between the CP group (22%) and MMC group (29%; p = .28). The actuarial 10-year overall survival and disease-free survival rate for the CP group was 54% and 49% and for the MMC group was 52% and 53%, respectively (p = .32 and p = .92, respectively). On multivariate analysis, male gender (p = .042) and advanced Stage T3-T4 disease (p <.0001) were statistically significant for worse disease-free survival. Stage T3-T4 (p = .039) and N+ (p = .039) disease remained independently significant for overall survival. Conclusion: Long-term follow-up has confirmed the good results of chemoradiotherapy with CP plus 5-fluorouracil, which seem to provide results equivalent to those with MMC plus 5-fluorouracil.

  10. Assessment of adherence to the guidelines for the management of nausea and vomiting induced by chemotherapy

    PubMed Central

    França, Monique Sedlmaier; Usón, Pedro Luiz Serrano; Antunes, Yuri Philippe Pimentel Vieira; Prado, Bernard Lobato; Donnarumma, Carlos del Cistia; Mutão, Taciana Sousa; Rodrigues, Heloisa Veasey; del Giglio, Auro

    2015-01-01

    ABSTRACT Objective: To assess adherence of the prescribing physicians in a private cancer care center to the American Society of Clinical Oncology guideline for antiemetic prophylaxis, in the first cycle of antineoplastic chemotherapy. Methods: A total of 139 chemotherapy regimens, of 105 patients, were evaluated retrospectively from 2011 to 2013. Results: We observed 78% of non-adherence to the guideline rate. The main disagreements with the directive were the prescription of higher doses of dexamethasone and excessive use of 5-HT3 antagonist for low risk emetogenic chemotherapy regimens. On univariate analysis, hematological malignancies (p=0.005), the use of two or more chemotherapy (p=0.05) and high emetogenic risk regimes (p=0.012) were factors statistically associated with greater adherence to guidelines. Treatment based on paclitaxel was the only significant risk factor for non-adherence (p=0.02). By multivariate analysis, the chemotherapy of high emetogenic risk most correlated with adherence to guideline (p=0.05). Conclusion: We concluded that the adherence to guidelines is greater if the chemotherapy regime has high emetogenic risk. Educational efforts should focus more intensely on the management of chemotherapy regimens with low and moderate emetogenic potential. Perhaps the development of a computer generated reminder may improve the adherence to guidelines. PMID:26154543

  11. Assessment of adherence to the guidelines for the management of nausea and vomiting induced by chemotherapy.

    PubMed

    França, Monique Sedlmaier; Usón Junior, Pedro Luiz Serrano; Antunes, Yuri Philippe Pimentel Vieira; Prado, Bernard Lobato; Donnarumma, Carlos del Cistia; Mutão, Taciana Sousa; Rodrigues, Heloisa Veasey; Giglio, Auro del

    2015-01-01

    To assess adherence of the prescribing physicians in a private cancer care center to the American Society of Clinical Oncology guideline for antiemetic prophylaxis, in the first cycle of antineoplastic chemotherapy. A total of 139 chemotherapy regimens, of 105 patients, were evaluated retrospectively from 2011 to 2013. We observed 78% of non-adherence to the guideline rate. The main disagreements with the directive were the prescription of higher doses of dexamethasone and excessive use of 5-HT3 antagonist for low risk emetogenic chemotherapy regimens. On univariate analysis, hematological malignancies (p=0.005), the use of two or more chemotherapy (p=0.05) and high emetogenic risk regimes (p=0.012) were factors statistically associated with greater adherence to guidelines. Treatment based on paclitaxel was the only significant risk factor for non-adherence (p=0.02). By multivariate analysis, the chemotherapy of high emetogenic risk most correlated with adherence to guideline (p=0.05). We concluded that the adherence to guidelines is greater if the chemotherapy regime has high emetogenic risk. Educational efforts should focus more intensely on the management of chemotherapy regimens with low and moderate emetogenic potential. Perhaps the development of a computer generated reminder may improve the adherence to guidelines.

  12. Chemotherapy-induced nausea and vomiting: pathophysiology and therapeutic principles.

    PubMed

    Bayo, Juan; Fonseca, Paula J; Hernando, Susana; Servitja, S; Calvo, A; Falagan, S; García, Estefanía; González, Iria; de Miguel, María José; Pérez, Quionia; Milena, Ana; Ruiz, Antonio; Barnadas, Agustí

    2012-06-01

    Chemotherapy-induced nausea and vomiting (CINV) is a major determinant of quality of life in cancer patients. In addition, the perceptions that oncology professionals have about CINV quite often do not coincide with reality. Antineoplastic agents and their combinations can be categorised according to their emetogenic level, and this categorisation is helpful for classifying the severity of CINV and treating it. All CINV treatment guidelines emphasise the need to administer prophylaxis to patients who receive highly or moderately emetogenic chemotherapy. With the introduction of NK1 receptor antagonists, the control of acute and delayed CINV after highly or moderately emetogenic chemotherapy schedules has improved in the great majority of patients. NK1 receptor antagonists have been demonstrated to improve the control of CINV in all risk subgroups of patients.

  13. Anterior gradient protein 2 expression in high grade head and neck squamous cell carcinoma correlated with cancer stem cell and epithelial mesenchymal transition.

    PubMed

    Ma, Si-Rui; Wang, Wei-Ming; Huang, Cong-Fa; Zhang, Wen-Feng; Sun, Zhi-Jun

    2015-04-20

    Anterior gradient protein 2 (AGR2) is a novel biomarker with potential oncogenic role. We sought to investigate the diagnostic and prognostic role of AGR2 on head and neck squamous cell carcinoma (HNSCC) with an emphasis on its correlation of cancer stemloid cells (CSC) and epithelial mesenchymal transition (EMT). We found that AGR2 protein levels were higher in HNSCC than in normal oral mucosa. High levels of AGR2 were associated with the T category, pathological grade and lymph node metastasis of HNSCC. Expression of AGR2 increased in recurring HNSCC after radiotherapy and in post cisplatin-based chemotherapeutic tissues. In HNSCC cell lines, knock-down of AGR2 induced apoptosis, reduced sphere formation, and down-regulated Survivin, Cyclin D1, Bcl2, Bcl2l1, Slug, Snail, Nanog and Oct4. In addition, over-expressed AGR2 in transgenic mice with spontaneous HNSCC was associated with lost function of Tgfbr1 and/ or lost function of Pten. In vitro knockdown TGFBR1 in HNSCC cell lines increased AGR2 expression. These results suggest that AGR2 is involved in EMT and self-renewal of CSC and may present a potential therapeutic target (oncotarget) for HNSCC.

  14. Rolapitant for the prevention of delayed nausea and vomiting over initial and repeat courses of emetogenic chemotherapy.

    PubMed

    Rapoport, Bernardo; van Eeden, Ronwyn; Smit, Teresa

    2017-01-01

    Chemotherapy-induced nausea and vomiting (CINV) is a debilitating side effect of many cytotoxic chemotherapy regimens. Although sustained antiemetic control across repeated chemotherapy cycles is important for cancer treatment continuation, few studies have investigated the efficacy of antiemetic prophylaxis over multiple chemotherapy cycles. Areas covered: Here we discuss the use of antiemetic hydroxytryptamine type 3 (5-HT3) receptor and neurokinin (NK)-1 receptor antagonists for prevention of CINV, limiting our review to clinical trials in the context of multiple-cycle chemotherapy, with a focus on the NK-1 receptor antagonist rolapitant. 5-HT3 receptor antagonists may be effective in controlling CINV over repeated chemotherapy cycles, but evidence comes primarily from noncomparative studies. NK-1 receptor antagonists provide increased protection against CINV but differences in endpoint selection and methods of analysis preclude meaningful comparisons between agents. Rolapitant shows sustained control of emesis and nausea over multiple cycles of chemotherapy, and compared to other NK-1 receptor antagonists, has a longer half-life and reduced potential for cytochrome P450 3A4-mediated drug-drug interactions. Expert commentary: Trial design should be a key consideration in future studies of CINV therapies, including analytical methods utilized, choice of endpoints, and methods for accounting for nonresponders and patient attrition over multiple cycles of chemotherapy.

  15. Pathological T0 Following Cisplatin-Based Neoadjuvant Chemotherapy for Muscle-Invasive Bladder Cancer: A Network Meta-analysis.

    PubMed

    Kim, Hyung Suk; Jeong, Chang Wook; Kwak, Cheol; Kim, Hyeon Hoe; Ku, Ja Hyeon

    2016-03-01

    To systematically assess and compare the relationship between various neoadjuvant chemotherapy regimens and pCR in patients with muscle-invasive bladder cancer. We performed a literature search of PubMed, Embase, and the Cochrane Library for all articles published before March 2015 and according to the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) guidelines. There were 17 articles that met the study eligibility criteria and were selected for the final analysis. A direct pair-wise meta-analysis was performed for studies that compared the same regimen. Finally, a Bayesian network meta-analysis was used to indirectly compare the regimens. In a pair-wise meta-analysis, the methotrexate/vinblastine/Adriamycin/cisplatin [MVAC; OR, 4.36; 95% confidence interval (CI), 2.71-7.02] and gemcitabine/cisplatin (GC) regimens (OR, 4.92; 95% CI, 2.93-8.24) were significantly associated with a better pCR than RC alone. In a network meta-analysis, there was no significant difference in terms of pCR achievement between the GC and MVAC regimens (OR, 1.14; 95% CI; 0.85-1.70). However, in a subgroup network meta-analysis that only included prospective randomized trials, the MVAC regimen was significantly correlated with a higher rate of pCR (OR, 5.75; 95% CI, 1.96-24.18). The results of this meta-analysis suggest that a GC regimen was associated with a pCR rate that was similar to that of a MVAC regimen based on retrospective data, but only the MVAC regimen was proven to achieve pCR in prospective randomized trials. Additional prospective randomized trials comparing both regimens will be necessary to establish the optimal neoadjuvant chemotherapy regimen. ©2015 American Association for Cancer Research.

  16. Cisplatin-based chemotherapy followed by focal, reduced-dose irradiation for pediatric primary central nervous system germinomas.

    PubMed

    Douglas, James G; Rockhill, Jason K; Olson, James M; Ellenbogen, Richard G; Geyer, J Russell

    2006-01-01

    The objective of this study was to evaluate retrospectively one institution's experience treating pediatric central nervous system (CNS) pure germinomas with platinum-based chemotherapy followed by focal, reduced-dose irradiation. Eight patients were identified with localized, pure CNS germinomas from 1993 to 2004 at the authors' institution. The median age at diagnosis was 13 years (range 7-19). The median follow-up was 40 months (range 8-141). The tumor location was suprasellar in four, the pineal region in three, and the third ventricle in one. Irradiation was started a median of 20 weeks (range 17-22) from diagnosis and consisted of conformal fields to the primary site as determined by the initial diagnostic MR plus a 1.5- to 2-cm margin. Six of the eight patients received a dose of 3,060 cGy; two patients received 3,600 cGy. The 5-year actuarial event free survival was 71% (56-86%, 95% CI). Two patients suffered marginal (at field edge) failures and both were salvaged using reinduction platinum-based chemotherapy followed by cranial spinal irradiation and a boost to the primary tumor. The 5-year actuarial overall survival was 100%. There were no spinal failures. These data suggest that a reduction in both volume and dose (30.6-36 Gy) retains the excellent survival rates for patients with localized, pure germinomas of the CNS. A higher rate of ventricular relapse rate is observed, although salvage of those patients is feasible.

  17. Multi-Institutional Assessment of Adverse Health Outcomes Among North American Testicular Cancer Survivors After Modern Cisplatin-Based Chemotherapy.

    PubMed

    Fung, Chunkit; Sesso, Howard D; Williams, Annalynn M; Kerns, Sarah L; Monahan, Patrick; Abu Zaid, Mohammad; Feldman, Darren R; Hamilton, Robert J; Vaughn, David J; Beard, Clair J; Kollmannsberger, Christian K; Cook, Ryan; Althouse, Sandra; Ardeshir-Rouhani-Fard, Shirin; Lipshultz, Steve E; Einhorn, Lawrence H; Fossa, Sophie D; Travis, Lois B

    2017-04-10

    Purpose To provide new information on adverse health outcomes (AHOs) in testicular cancer survivors (TCSs) after four cycles of etoposide and cisplatin (EPX4) or three or four cycles of bleomycin, etoposide, cisplatin (BEPX3/BEPX4). Methods Nine hundred fifty-two TCSs > 1 year postchemotherapy underwent physical examination and completed a questionnaire. Multinomial logistic regression estimated AHOs odds ratios (ORs) in relation to age, cumulative cisplatin and/or bleomycin dose, time since chemotherapy, sociodemographic factors, and health behaviors. Results Median age at evaluation was 37 years; median time since chemotherapy was 4.3 years. Chemotherapy consisted largely of BEPX3 (38.2%), EPX4 (30.9%), and BEPX4 (17.9%). None, one to two, three to four, or five or more AHOs were reported by 20.4%, 42.0%, 25.1%, and 12.5% of TCSs, respectively. Median number after EPX4 or BEPX3 was two (range, zero to nine and zero to 11, respectively; P > .05) and two (range, zero to 10) after BEPX4. When comparing individual AHOs for EPX4 versus BEPX3, Raynaud phenomenon (11.6% v 21.4%; P < .01), peripheral neuropathy (29.2% v 21.4%; P = .02), and obesity (25.5% v 33.0%; P = .04) differed. Larger cumulative bleomycin doses (OR, 1.44 per 90,000 IU) were significantly associated with five or more AHOs. Increasing age was a significant risk factor for one to two, three to four, or five or more AHOs versus zero AHOs (OR, 1.22, 1.50, and 1.87 per 5 years, respectively; P < .01); vigorous physical activity was protective (OR, 0.62, 0.51, and 0.41, respectively; P < .05). Significant risk factors for three to four and five or more AHOs included current (OR, 3.05 and 3.73) or former (OR, 1.61 and 1.76) smoking ( P < .05). Self-reported health was excellent/very good in 59.9% of TCSs but decreased as AHOs increased ( P < .001). Conclusion Numbers of AHOs after EPX4 or BEPX3 appear similar, with median follow-up of 4.3 years. A healthy lifestyle was associated with reduced number of AHOs.

  18. Prevention of Nausea and Vomiting in Patients Undergoing Oral Anticancer Therapies for Solid Tumors

    PubMed Central

    Abreu, Catarina; Pacheco, Teresa Raquel; Sousa, Ana Rita; Pulido, Catarina; Quintela, António; Costa, Luís

    2015-01-01

    Chemotherapy-induced nausea and vomiting (CINV) is still a common and debilitating side effect despite recent advances in its prevention and treatment. The intrinsic emetogenicity of chemotherapy agents allowed grouping into four risk groups (high, moderate, low, and minimal risk of emetogenicity). The prevention of acute and delayed CINV for intravenous agents and one day regimens is well studied, although, there are few data about management of CINV induced by oral cytotoxic agents and targeted therapies, usually administered in extended regimens of daily oral use. Until now treatment of nausea and vomiting caused by oral antineoplastic agents remains largely empirical. The level of evidence of prophylactic antiemetics recommended for these agents is low. There are differences in the classification of emetogenic potential of oral antineoplastic agents between the international guidelines and different recommendations for prophylactic antiemetic regimens. Herein we review the evidence for antiemetic regimens for the most used oral antineoplastic agents for solid tumors and propose antiemetic regimens for high to moderate risk and low to minimal risk of emetogenicity. PMID:26421283

  19. Prevention of Nausea and Vomiting in Patients Undergoing Oral Anticancer Therapies for Solid Tumors.

    PubMed

    Costa, Ana Lúcia; Abreu, Catarina; Pacheco, Teresa Raquel; Macedo, Daniela; Sousa, Ana Rita; Pulido, Catarina; Quintela, António; Costa, Luís

    2015-01-01

    Chemotherapy-induced nausea and vomiting (CINV) is still a common and debilitating side effect despite recent advances in its prevention and treatment. The intrinsic emetogenicity of chemotherapy agents allowed grouping into four risk groups (high, moderate, low, and minimal risk of emetogenicity). The prevention of acute and delayed CINV for intravenous agents and one day regimens is well studied, although, there are few data about management of CINV induced by oral cytotoxic agents and targeted therapies, usually administered in extended regimens of daily oral use. Until now treatment of nausea and vomiting caused by oral antineoplastic agents remains largely empirical. The level of evidence of prophylactic antiemetics recommended for these agents is low. There are differences in the classification of emetogenic potential of oral antineoplastic agents between the international guidelines and different recommendations for prophylactic antiemetic regimens. Herein we review the evidence for antiemetic regimens for the most used oral antineoplastic agents for solid tumors and propose antiemetic regimens for high to moderate risk and low to minimal risk of emetogenicity.

  20. Palonosetron for the prevention of chemotherapy-induced nausea and vomiting in patients with cancer.

    PubMed

    Navari, Rudolph M

    2010-07-01

    Chemotherapy-induced nausea and vomiting (CINV) is associated with a significant deterioration in quality of life. The emetogenicity of the chemotherapeutic agents, repeated chemotherapy cycles and patient characteristics (e.g., female gender, younger age, low alcohol consumption and history of motion sickness) are the major risk factors for CINV. This article provides a detailed description of palonosetron, a second-generation 5-hydroxytryptamine-3 (5-HT(3)) receptor antagonist, which has been approved for the prevention of acute CINV in patients receiving either moderately or highly emetogenic chemotherapy and for the prevention of delayed CINV in patients receiving moderately emetogenic chemotherapy. In recent studies, compared with the first-generation 5-HT(3) receptor antagonists, palonosetron in combination with dexamethasone demonstrated better control of delayed CINV in patients receiving highly emetogenic chemotherapy and had a similar safety profile. Owing to its efficacy in controlling both acute and delayed CINV, palonosetron may be very effective in the clinical setting of multiple-day chemotherapy and bone marrow transplantation.

  1. Use of transdermal and intravenous granisetron and the ability of the Hesketh score to assess nausea and vomiting induced by multiday chemotherapy

    PubMed Central

    Boccia, Ralph V; Clark, Gemma; Howell, Julian D

    2012-01-01

    Purpose Hesketh scores define emetogenicity of single-agent and multiagent single-day chemotherapy. This analysis determined the emetogenicity of multiagent, multiday chemotherapy and the Granisetron Transdermal System (GTDS; Sancuso®). Methods This was a retrospective analysis of a multicenter, randomized, double-blind, phase III noninferiority trial of GTDS versus oral granisetron in patients receiving 3 days of multiagent moderately or highly emetogenic chemotherapy, regardless of granisetron formulation. Emesis was defined as vomiting/retching or the use of rescue medication. Logistic regression and classification trees were used to determine the optimal combination of Hesketh scores over the multiagent, multiday regimens for the prediction of emesis. Results Of 393 patients, 272 (69.2%) were chemotherapy naïve. The most common types of cancer were lung (30.5%) and gynecologic (21.9%). The most common chemotherapeutic regimen (in 14.2% of patients) was cisplatin plus etoposide on days 1–3. The best binary emesis predictor was day 1 Hesketh score. Patients with a day 1 Hesketh score of 5 had the highest rate of emesis (62.5%) versus patients with a score < 5 (31.7%). For patients with day 1 Hesketh score < 5, only 14.3% of those receiving only one drug on day 1 experienced emesis. Conclusion Hesketh emetogenicity scores of individual agents are applicable to multiday, multiagent chemotherapeutic regimens in patients receiving antiemetics. PMID:22904638

  2. 2016 updated MASCC/ESMO consensus recommendations: Prevention of acute chemotherapy-induced nausea and vomiting in children.

    PubMed

    Dupuis, L Lee; Sung, Lillian; Molassiotis, Alexander; Orsey, Andrea D; Tissing, Wim; van de Wetering, Marianne

    2017-01-01

    To update the 2009 recommendations for the prevention of acute chemotherapy-induced emesis in children. We updated the original systematic literature search. Randomized studies were included in the evidence to support this guideline if they were primary studies fully published in full text in English or French; included only children less than 18 years old or, for mixed studies of adults and children, reported the pediatric results separately or the median or mean age was no more than 13 years; evaluated acute chemotherapy-induced nausea and vomiting (CINV) prophylaxis; provided sufficient information to permit determination of the emetogenicity of the antineoplastic therapy administered or the study investigators stated the emetogenicity of the chemotherapy administered; included an implicit or explicit definition of complete acute CINV response; described the antiemetic regimen in full; and reported the complete acute CINV response rate as a proportion. Twenty-five randomized studies, including eight published since 2009, met the criteria for inclusion in this systematic review. Prophylaxis with a 5-HT3 antagonist (granisetron or ondansetron or palonosetron or tropisetron) ± dexamethasone ± aprepitant is recommended for children receiving highly or moderately emetogenic chemotherapy. For children receiving chemotherapy of low emetogenicity, a 5-HT3 antagonist is recommended. The findings of several randomized trials were used to update recommendations for the prevention of acute CINV. However, significant research gaps remain and must be addressed before CINV control in children can be optimized.

  3. Consensus Recommendations from the Spanish Germ Cell Cancer Group on the Use of High-dose Chemotherapy in Germ Cell Cancer.

    PubMed

    González-Billalabeitia, Enrique; Sepúlveda, Juan Manuel; Maroto, Pablo; Aparicio, Jorge; Arranz, Jose Angel; Esteban, Emilio; Gironés, Regina; López-Brea, Marta; Mendez-Vidal, María José; Pinto, Alvaro; Sastre, Javier; de Prado, Diego Soto; Terrasa, Josefa; Vázquez, Sergio; Powles, Thomas; Beyer, Jörg; Castellano, Daniel; Del Muro, Xavier García

    2016-07-18

    High-dose chemotherapy (HDCT) has been studied in several clinical scenarios in advanced germ cell cancer (GCC). To establish a clinical practice guideline for HDCT use in the treatment of GCC patients. An expert panel reviewed information available from the literature. The panel addressed relevant issues concerning and related to HDCT. The guideline was externally reviewed by two international experts. The efficacy of HDCT has been demonstrated in selected GCC patients. The most conclusive evidence comes from retrospective analyses that need to be interpreted with caution. HDCT can cure a significant proportion of heavily treated GCC patients. When indicated, sequential HDCT with regimens containing carboplatin and etoposide, as well as peripheral stem-cell support, is recommended. There is no conclusive evidence to recommend HDCT as first-line therapy. According to a multinational retrospective pooled analysis, HDCT might be superior to conventional CT as first salvage treatment in selected patients. There is an urgent need for prospective clinical trials addressing the value of HDCT in GCC patients who experience failure on first-line cisplatin-based CT. In patients who progress on conventional-dose salvage CT, HDCT should be considered. Treatment of these patients at experienced centers is strongly recommended. It has been demonstrated that HDCT cures selected GCC patients who experience disease progression on conventional rescue regimens. The panel recommends the inclusion of GCC patients in randomized clinical trials including HDCT. This consensus establishes clinical practice guidelines for the use and study of high-dose chemotherapy in patients with germ cell cancer. Copyright © 2016. Published by Elsevier B.V.

  4. Role of the Human High-Affinity Copper Transporter (hCtr1) in Copper Homeostasis Regulation and Cisplatin Sensitivity in Cancer Chemotherapy

    PubMed Central

    Kuo, Macus Tien; Fu, Siqing; Savaraj, Niramol; Chen, Helen H. W.

    2012-01-01

    The high-affinity copper transporter (Ctr1) (SCLC31A1) plays an important role in regulating Cu homeostasis because copper (Cu) is an essential micronutrient and Cu deficiency is detrimental to many important cellular functions but excess Cu is toxic. Recent research has revealed that human Cu homeostasis is tightly controlled by interregulatory circuitry involving Cu, Sp1 and hCtr1. This circuitry uses Sp1 transcription factor as a Cu sensor in modulating hCtr1 expression which in turn controls cellular Cu and Sp1 levels in a three-way mutual regulatory loop. Posttranslational regulation of hCtr1 expression by Cu stresses has also been described in the literature. Because hCtr1 can also transport platinum (Pt) drugs, this finding underscores the important role of hCtr1 in Pt drug sensitivity in cancer chemotherapy. Consistent with this notion is the findings that elevated hCtr1 expression was associated with favorable treatment outcomes in cisplatin-based cancer chemotherapy. Moreover, cultured cell studies demonstrated that elevated hCtr1 expression can be induced by depleting cellular Cu levels, resulting in enhanced cisplatin uptake and its cell killing activity. A phase 1 clinical trial using a combination of trientine (a Cu chelator) and carboplatin has been performed with encouraging results. This review discusses new insights into the role of hCtr1 in regulating Cu homeostasis and explains how modulating cellular Cu availability could influence treatment efficacy in platinum-based cancer chemotherapy through hCtr1 regulation. PMID:22962276

  5. Effect of Concurrent High-Dose Cisplatin Chemotherapy and Conformal Radiotherapy on Cervical Esophageal Cancer Survival

    SciTech Connect

    Huang Shaohui; Lockwood, Gina; Brierley, James; Cummings, Bernard; Kim, John; Wong, Rebecca; Bayley, Andrew; Ringash, Jolie

    2008-07-01

    Purpose: To determine whether a change in treatment policy to conformal, elective nodal radiotherapy and concurrent high-dose cisplatin improved survival for cervical esophageal cancer patients. Methods and Materials: All cervical esophageal cancer patients treated between 1997 and 2005 were restaged (1983 American Joint Committee on Cancer criteria). Patients treated before 2001 (previous cohort [PC]) were compared with those treated from 2001 onward (recent cohort [RC]). The PC institutional chemoradiotherapy protocol was 54 Gy in 20 fractions within 4 weeks, with 5-fluorouracil (1,000 mg/m{sup 2}) on Days 1-4 and either mitomycin C (10 mg/m{sup 2}) or cisplatin (75 mg/m{sup 2}) on Day 1. The RC institutional chemoradiotherapy protocol was conformal radiotherapy, 70 Gy in 35 fractions within 7 weeks, to the primary tumor and elective nodes, with high-dose cisplatin (100 mg/m{sup 2}) on Days 1, 22, and 43. Results: The median follow-up was 3.1 years (PC, 8.1 and RC, 2.3). Of 71 patients (25 women and 46 men), 21 of 29 in the PC and 29 of 42 in the RC were treated curatively (curative subgroup, n = 50). Between the two groups, no differences in overall survival or locoregional relapse-free survival were seen. The overall survival rate at 2 and 5 years was 35% (range, 24-47%) and 21% (range, 12-32%) in the whole group and 46% (range 32-60%) and 28% (range, 15-42%) in the curative group, respectively. In the curative group, no statistically significant prognostic factors were found. Trends toward better locoregional relapse-free survival were seen in women (2-year rate, 73% vs. for men, 36%; p = 0.08) and in patients aged >64 years (2-year rate, 68% vs. age {<=}64 years, 34%; p = 0.10). Conclusion: No survival improvement could be demonstrated after changing the treatment policy to high-dose cisplatin-based, conventionally fractionated conformal chemoradiotherapy. Female gender and older age might predict for better outcomes.

  6. Inverse Planned High-Dose-Rate Brachytherapy for Locoregionally Advanced Cervical Cancer: 4-Year Outcomes

    SciTech Connect

    Tinkle, Christopher L.; Weinberg, Vivian; Chen, Lee-May; Littell, Ramey; Cunha, J. Adam M.; Sethi, Rajni A.; Chan, John K.; Hsu, I-Chow

    2015-08-01

    Purpose: Evaluate the efficacy and toxicity of image guided brachytherapy using inverse planning simulated annealing (IPSA) high-dose-rate brachytherapy (HDRB) boost for locoregionally advanced cervical cancer. Methods and Materials: From December 2003 through September 2009, 111 patients with primary cervical cancer were treated definitively with IPSA-planned HDRB boost (28 Gy in 4 fractions) after external radiation at our institution. We performed a retrospective review of our experience using image guided brachytherapy. Of the patients, 70% had a tumor size >4 cm, 38% had regional nodal disease, and 15% had clinically evident distant metastasis, including nonregional nodal disease, at the time of diagnosis. Surgical staging involving pelvic lymph node dissection was performed in 15% of patients, and 93% received concurrent cisplatin-based chemotherapy. Toxicities are reported according to the Common Terminology Criteria for Adverse Events version 4.0 guidelines. Results: With a median follow-up time of 42 months (range, 3-84 months), no acute or late toxicities of grade 4 or higher were observed, and grade 3 toxicities (both acute and late) developed in 8 patients (1 constitutional, 1 hematologic, 2 genitourinary, 4 gastrointestinal). The 4-year Kaplan-Meier estimate of late grade 3 toxicity was 8%. Local recurrence developed in 5 patients (4 to 9 months after HDRB), regional recurrence in 3 (6, 16, and 72 months after HDRB), and locoregional recurrence in 1 (4 months after HDR boost). The 4-year estimates of local, locoregional, and distant control of disease were 94.0%, 91.9%, and 69.1%, respectively. The overall and disease-free survival rates at 4 years were 64.3% (95% confidence interval [CI] of 54%-73%) and 61.0% (95% CI, 51%-70%), respectively. Conclusions: Definitive radiation by use of inverse planned HDRB boost for locoregionally advanced cervical cancer is well tolerated and achieves excellent local control of disease. However, overall

  7. Multicenter phase II trial of accelerated cisplatin and high-dose epirubicin followed by surgery or radiotherapy in patients with stage IIIa non-small-cell lung cancer with mediastinal lymph node involvement (N2-disease)

    PubMed Central

    Phernambucq, E C J; Biesma, B; Smit, E F; Paul, M A; Tol, A vd; Schramel, F M; Bolhuis, R J; Postmus, P E

    2006-01-01

    To assess the therapeutic activity of accelerated cisplatin and high-dose epirubicin with erythropoietin and G-CSF support as induction therapy for patients with stage IIIa-N2 non-small-cell lung cancer (NSCLC). Patients with stage IIIa-N2 NSCLC were enrolled in a phase II trial. They received cisplatin 60 mg m−2 and epirubicin 135 mg m−2 every 2 weeks for three courses combined with erythropoietin and G-CSF. Depending on results of clinical response to induction therapy and restaging, patients were treated with surgery or radiotherapy. In total, 61 patients entered from March 2001 to April 2004. During 169 courses of induction chemotherapy, National Cancer Institute of Canada (NCI-C) grade III/IV leucocytopenia was reported in 35 courses (20.7%), NCI-C grade III/IV thrombocytopenia in 26 courses (15.4%) and NCI-C grade III/IV anaemia in six courses (3.6%). Main cause of cisplatin dose reduction was nephrotoxicity (12 courses). Most patients received three courses. There were no chemotherapy-related deaths. Three patients were not evaluable for clinical response. Twenty-eight patients had a partial response (48.3%, 95% CI: 36–61.1%), 24 stable disease and six progressive disease. After induction therapy, 30 patients underwent surgery; complete resection was achieved in 19 procedures (31.1%). Radical radiotherapy was delivered to 25 patients (41%). Six patients were considered unfit for further treatment. Median survival for all patients was 18 months. Response rate of accelerated cisplatin and high-dose epirubicin as induction chemotherapy for stage IIIa-N2 NSCLC patients is not different from more commonly used cisplatin-based regimen. PMID:16909132

  8. Anatomy-based definition of point A utilizing three-dimensional volumetric imaging approach for high-dose-rate (HDR) intracavitary brachytherapy dose prescription when treating cervical cancer using limited resources.

    PubMed

    Goyal, Manish K; Rai, D V; Kehwar, Than S; Manjhi, Jayanand; Heintz, Bret H; Shide, Kathleen L; Barker, Jerry L

    2016-07-16

    This study was designed to determine whether volumetric imaging could identify consistent alternative prescription methods to Manchester/point A when prescribing radiation dose in the treatment of cervical cancer using HDR intracavitary brachy-therapy (ICBT). One hundred and twenty-five treatment plans of 25 patients treated for carcinoma of the cervix were reviewed retrospectively. Each patient received 5 fractions of HDR ICBT following initial cisplatin-based pelvic chemoradiation, and radiation dose was originally prescribed to point A (ICRU-38). The gross tumor volume (GTV) and high-risk clinical target volume (HR-CTV) were contoured in three dimensions on the CT datasets, and inferior-superior, anterior-posterior, and left-right dimensions HR-CTV were recorded along with multiple anatomic and skeletal dimensions for each patient. The least square-best fit regression lines were plotted between one half of the HR-CTV width and pelvic cavity dimension at femoral head level and at maximum cavity dimension. The points in both plots lie reasonably close to straight lines and are well defined by straight lines with slopes of 0.15 and 0.17; intercept on y-axes of -0.08 and -0.03, point A, at the same level as defined based on applicator coordinates, is defined using this correlation, which is a function of distance between femoral heads/dimensions of maximum pelvic cavity width. Both relations, defined by straight lines, provide an estimated location of point A, which provides adequate coverage to the HR-CTV compared to the point A defined based on applicator coordinates. The point A defined based on femoral head distance would, therefore, be a reasonable surrogate to use for dose prescription because of subjective variation of cavity width dimension. Simple surrogate anatomic/skeletal landmarks can be useful for prescribing radiation dose when treating cervical cancer using intracavitary brachytherapy in limited-resource settings. Our ongoing work will continue to

  9. A comparative study of cisplatin-based definitive chemo-radiation in non-metastatic squamous cell carcinoma of the esophagus

    PubMed Central

    Mofid, Bahram; Razzaghdoust, Abolfazl; Kashi, Amir Shahram Yousefi; Mirzaei, Hamid Reza

    2016-01-01

    Introduction Esophageal cancer is the seventh most frequent malignancy in Iranian men and the fourth most common cancer in Iranian women. It is also among the 10 most frequent cancers in the world. Definitive chemo-radiation using cisplatin with 5-fluorouracil (5-FU) is known as the standard of care among various chemotherapy regimens used with esophageal cancer patients who are not eligible for surgery. Cisplatin with paclitaxel and cisplatin with irinotecan also have been used often during the past five years. The aim of this research was to compare overall survival (OS) and hematological toxicity rates between these regimens. Methods This single-institutional study included 55 patients who were treated with definitive chemo-radiation in the radiation-oncology ward at Shohada-e-Tajrish Hospital in Tehran, Iran, between 2006 and 2013. They received one of four regimens, i.e., cisplatin, cisplatin with 5-FU (old chemotherapy regimens), cisplatin with paclitaxel, or cisplatin with irinotecan (new chemotherapy regimens) as part of their definitive chemo-radiation with curative intent. The Kaplan-Meier estimator was used to estimate the overall survival times, which were compared by using the Breslow test. Results The follow-up period was between 26–109 months, with a median of 72 months. OS was not different between the old and new chemotherapy regimen groups (p = 0.18). Hematological toxicity (leucopenia) in the old chemotherapy regimen groups (10%) was significantly lower than in the new chemotherapy regimen groups (43%, p = 0.012). But OS in cisplatin or cisplatin with 5-FU scheme was statistically better than with the cisplatin with paclitaxel scheme (p = 0.026, p = 0.028, respectively). Conclusion This study showed that OS are similar in both the old and new chemotherapy treatment regimens in esophageal cancer patients who were treated with definitive chemo-radiation. The new chemotherapy treatment regimens should be used with caution as an alternative treatment of cisplatin with 5-FU for further evaluation. PMID:27957305

  10. Clinical Significance of Early Changes in Circulating Tumor Cells from Patients Receiving First-Line Cisplatin-Based Chemotherapy for Metastatic Urothelial Carcinoma1

    PubMed Central

    Fina, Emanuela; Necchi, Andrea; Giannatempo, Patrizia; Colecchia, Maurizio; Raggi, Daniele; Daidone, Maria Grazia; Cappelletti, Vera

    2016-01-01

    Background: The therapeutic paradigm of metastatic urothelial carcinoma (UC) is rapidly shifting and new biomarkers are needed to enhance patient selection. Objective: Early identification of dynamic predictors of outcome may be a key to optimize the sequence of effective therapies in metastatic UC patients. Methods: Blood samples from patients receiving first-line MVAC chemotherapy were collected at baseline (T0) and after 2 cycles (T2). Samples were processed by immunomagnetic beads (AdnaTest ProstateCancerSelect kit) and the expression of EPCAM, MUC1 and ERBB2 was studied using multiplex-PCR. Circulating tumor cell (CTC) positivity and cutoffs, obtained by receiver operator characteristic (ROC) curve analysis in healthy donors, were: ≥1 positive marker among EPCAM (≥0.40 ng/μl), MUC1 (≥0.10 ng/μl) and ERBB2 (≥0.20 ng/μl). CTC variation (T0/T2) was split in favorable (+/–, –/–, –/+) and unfavorable groups (+/+). Cox regression analyses evaluated associations with clinical factors. Results: In this pilot study to assess a new CTC detection method, among 31 evaluable patients, 17 (54.8%) were CTC-positive at T0. No association was found between CTC and objective response to MVAC. CTC dynamic changes better predicted 3-year progression-free (PFS) and overall survival (OS) compared to CTC status assessed at single time points. Unfavorable trend was univariably detrimental on 3-year PFS (10% vs. 49.2%, p = 0.006) and OS (20% vs. 63.5%, p = 0.017). Significance was maintained after controlling for liver metastases (p = 0.031 and p = 0.025 for PFS and OS) and MSKCC score (p = 0.014 and 0.025). Conclusions: Newly described early CTC changes during chemotherapy might be useful to improve our prognostic ability. Pending validation, these results could fulfill the promise to help accelerating therapeutic sequences. PMID:28035320

  11. Non-pineal supratentorial primitive neuro-ectodermal tumors (sPNET) in teenagers and young adults: Time to reconsider cisplatin based chemotherapy after cranio-spinal irradiation?

    PubMed

    Biswas, Swethajit; Burke, Amos; Cherian, Sheen; Williams, Denise; Nicholson, James; Horan, Gail; Jefferies, Sarah; Williams, Michael; Earl, Helena M; Burnet, Neil G; Hatcher, Helen

    2009-07-01

    Supratentorial PNET (sPNET) are rare CNS tumors of embryonal origin arising in children and adults. The treatment of sPNET for all age groups at our cancer center has been based on the management of medulloblastoma (MB), involving neurosurgical debulking followed by cranio-spinal irradiation (CSI) and systemic chemotherapy. Medical records were reviewed to gather demographic and clinical data about all embryonal CNS tumors in children and adults from 2001 to 2007. Tumor pathology, clinical management and survival data were also assessed, particularly as regards those patients who received the Packer chemotherapy regimen for either sPNET or MB. Eleven patients (five children and six adults) were identified with non-pineal sPNET, three children with pineal sPNET, and 19 patients (18 children and 1 adult) with MB. There was no difference in overall survival (OS) rates between pediatric and adult sPNET. When all sPNET were compared to all MB, 5-year OS was 14% versus 73%, respectively, but was only 9% for non-pineal sPNET. When only considering those patients treated with the Packer chemotherapy regimen, the 5-year OS was 12% for sPNET versus 79% for MB. This retrospective study demonstrates that non-pineal sPNET are clinically distinct from MB and are resistant to the Packer chemotherapy regimen. We suggest that it is time to reconsider the use of this regimen in teenage and young adult non-pineal sPNET and to investigate the utility of alternative approaches. (c) 2009 Wiley-Liss, Inc.

  12. IL-17A exacerbates cisplatin-based resistance of OVCA via upregulating the expression of ABCG2 and MDR1 through Gli1-mediated Hh signaling.

    PubMed

    Niu, Xiulong; Liu, Wenxing; Wang, Yue; Liu, Xiaomei; Zhang, Hongjian; Li, Zhijun; Li, Hongzhao; Iwakura, Yoichiro; Deng, Weimin

    2016-07-18

    The major obstacle of the tumor chemotherapy, including ovarian cancer (OVCA), is drug resistance. However, the relevance of IL-17A with drug-resistance of OVCA has been poorly elaborated. In this study, we used 2 human OVCA cell lines to investigate the effects of IL-17A on cisplatin (CDDP or DDP)-based resistance in OVCA cells and the underlying mechanisms. Meanwhile, IL-17A-deficient mice and ID8 were used to verify the IL-17A's effects on OVCA chemo-resistance in vivo. Moreover, the relationship between IL-17A level and relevant indices were primarily assessed in ovarian specimens from 55 patients with OVCA. We found that rhIL-17A exacerbated DDP-based resistance of OVCA cells via up-regulating the expression of ABCG2 and MDR1 through Gli1-mediated Hh signal pathway. Animal experiment demonstrated that IL-17A significantly recede DDP-based treatment for ID8 tumor. Similar results were observed in preliminary clinical investigation. Our findings suggest that inhibiting IL-17A/IL-17RA-Gli1 signal may improve the resistance of OVCA to DDP.

  13. Reduced and Compressed Cisplatin-Based Chemotherapy in Children and Adolescents With Intermediate-Risk Extracranial Malignant Germ Cell Tumors: A Report From the Children's Oncology Group.

    PubMed

    Shaikh, Furqan; Cullen, John W; Olson, Thomas A; Pashankar, Farzana; Malogolowkin, Marcio H; Amatruda, James F; Villaluna, Doojduen; Krailo, Mark; Billmire, Deborah F; Rescorla, Frederick J; Egler, Rachel A; Dicken, Bryan J; Ross, Jonathan H; Schlatter, Marc; Rodriguez-Galindo, Carlos; Frazier, A Lindsay

    2017-04-10

    Purpose To investigate whether event-free survival (EFS) can be maintained among children and adolescents with intermediate-risk (IR) malignant germ cell tumors (MGCT) if the administration of cisplatin, etoposide, and bleomycin (PEb) is reduced from four to three cycles and compressed from 5 to 3 days per cycle. Patients and Methods In a phase 3, single-arm trial, patients with IR MGCT (stage II-IV testicular, II-III ovarian, I-II extragonadal, or stage I gonadal tumors with subsequent recurrence) received three cycles of PEb. A parametric comparator model specified that the observed EFS rate should not be significantly < 92%. As recommended for trials that test a reduction of therapy, a one-sided P value ≤ .10 was used to indicate statistical significance. In a post hoc analysis, we also compared results to the EFS rate of comparable patients treated with four cycles of PEb in two prior studies. Results Among 210 eligible patients enrolled from 2003 to 2011, 4-year EFS (EFS4) rate was 89% (95% confidence interval, 83% to 92%), which was significantly lower than the 92% threshold of the comparison model ( P = .08). Among 181 newly diagnosed patients, the EFS4 rate was 87%, compared with 92% for 92 comparable children in the historical cohort ( P = .15). The EFS4 rate was significantly associated with stage (stage I, 100%; stage II, 92%; stage III, 85%; and stage IV, 54%; P < .001). Conclusion The EFS rate for children with IR MGCT observed after three cycles of PEb was less than that of a prespecified parametric model, particularly for patients with higher-stage tumors. These data do not support a reduction in the number of cycles of PEb from four to three. However, further investigation of a reduction in the number of cycles for patients with lower-stage tumors is warranted.

  14. A Phase II Multi-institutional Trial of Chemoradiation Using Weekly Docetaxel and Erythropoietin for High-Risk Postoperative Head and Neck Cancer Patients

    SciTech Connect

    Willey, Christopher D.; Murphy, Barbara A.; Netterville, James L.; Burkey, Brian B.; Shyr, Yu; Shakhtour, Bashar; Kish, Bonnie; Raben, David; Chen Changhu; Song, John I.; Kane, Madeleine A.; Cmelak, Anthony J. . E-mail: anthony.cmelak@vanderbilt.edu

    2007-04-01

    Purpose: To determine efficacy and toxicities of postoperative concurrent chemoradiation using docetaxel in high-risk head and neck cancer. Methods and Materials: High-risk patients were enrolled 2-8 weeks after surgery. Treatment included 60 Gy for 6 weeks with weekly docetaxel 25 mg/m{sup 2} and erythropoietin alpha 40,000 U for hemoglobin {<=}12 g/dL. Primary endpoints included locoregional control (LC), disease-free survival (DFS), and patterns of failure (POF). Secondary endpoints were toxicity and quality of life. Results: Eighteen patients were enrolled (14 male, 4 female), aged 24-70 years (median, 55 years). Primary site included oropharynx = 7, oral cavity 8, hypopharynx = 1, and larynx = 2. Pathologic American Joint Committee on Cancer Stage was III = 3 patients, IV = 15 patients. High-risk eligibility included {>=}2 positive lymph nodes = 13, extracapsular extension = 10, positive margins = 8 (11 patients with two or more risk factors). Docetaxel was reduced to 20 mg/m{sup 2}/week after 5 patients had prolonged Grade 3 or higher mucositis. Overall, number of doses delivered was 2 of 6 = 1, 3 of 6 2, 4 of 6 = 2, 5 of 6 = 4, 6 of 6 = 9 patients. With median follow-up of 30 months (range, 5-66), 10 (56%) patients are alive and have no evidence of disease (NED); POF: three local recurrences (two with distant) and 1 distant only. One-year survival was 76%, median PFS and DFS had not been reached. Three-year LC was 82%. No Grade 3 or higher late toxicities were observed, although a few cases of prolonged mucositis and taste loss (>3 months) were seen, particularly at 25 mg/m{sup 2}/week. Conclusion: Postoperative radiation therapy with weekly docetaxel 20 or 25 mg/m{sup 2}/week for high-risk postoperative head and neck cancer caused intolerable mucosal toxicity, prompting early study termination. Further studies should consider 15 mg/m{sup 2}. Actuarial 3-year LC is 82%, similar to cisplatin-based chemoradiation regimens. Distant metastasis remains an

  15. Prevention of chemotherapy-induced nausea and vomiting and the role of neurokinin 1 inhibitors: from guidelines to clinical practice in solid tumors.

    PubMed

    Di Maio, Massimo; Bria, Emilio; Banna, Giuseppe L; Puglisi, Fabio; Garassino, Marina C; Lorusso, Domenica; Perrone, Francesco

    2013-02-01

    A significant proportion of cancer patients experience nausea or vomiting during the course of their disease, either because of the cancer itself or because of the treatment received. Highly or moderately emetogenic drugs are part of the standard chemotherapy regimens frequently used in patients with lung cancer, breast cancer, ovarian cancer, and several other common solid tumors. In this review, we describe the impact of nausea and vomiting in patients receiving chemotherapy, and the main progress achieved in the prophylaxis of chemotherapy-induced nausea and vomiting with the introduction of neurokinin 1 inhibitors. The adherence to existing guidelines is particularly important to avoid suboptimal prophylaxis and maximize patients' outcome. This review is focused on lung, breast, ovarian, and colorectal cancer, which are among the solid tumors characterized by a numeric and clinical relevance of the chemotherapy-induced nausea and vomiting issue because of the wide use of highly and/or moderately emetogenic chemotherapy regimens.

  16. Practical use of perioperative chemotherapy for muscle-invasive bladder cancer: summary of session at the Society of Urologic Oncology annual meeting.

    PubMed

    Apolo, Andrea B; Grossman, Herbert Barton; Bajorin, Dean; Steinberg, Gary; Kamat, Ashish M

    2012-01-01

    At the 11th annual meeting of the Society of Urologic Oncology, an expert panel was convened to discuss the practical use of perioperative chemotherapy for muscle-invasive bladder cancer. The discussion was structured as a case-based debate among the panelists. The topics included: neoadjuvant chemotherapy with a focus on T2 disease, pros and cons, survival data, tolerability of cisplatin-based therapy, can we avoid radical cystectomy in complete responders, limitations and alternatives to cisplatin-based therapy, management of 'suboptimal' chemotherapy, residual disease after neoadjuvant chemotherapy, adjuvant chemotherapy, and key aspects of radical cystectomy and lymph-node dissection in multimodal therapy. The presentations were derived from published literature. The panelists agreed that patients with muscle-invasive bladder cancer should be managed with a multidisciplinary team, including urologist and medical oncologist. Cisplatin-based neoadjuvant chemotherapy has demonstrated improved survival and should be incorporated into the management of all eligible patients with muscle-invasive bladder cancer. However, in some centers, neoadjuvant chemotherapy is reserved for patients with >T2 disease or high-risk features. There are no data for the administration of non-cisplatin-based neoadjuvant chemotherapy, such as carboplatin-combinations. Cisplatin-ineligible patients should proceed directly to surgical extirpation with adjuvant cisplatin-based chemotherapy considered based on pathologic findings. However, the data for adjuvant chemotherapy is less compelling. As our refinement of the selection process continues, we may be able to better identify subsets of patients who may be spared chemotherapy, but much work remains to be done in this arena. The current standard for muscle-invasive bladder cancer patients is cisplatin-based neoadjuvant chemotherapy followed by radical cystectomy and pelvic lymph-node dissection.

  17. Practical Use of Perioperative Chemotherapy for Muscle-Invasive Bladder Cancer: Summary of Session at the Society of Urologic Oncology Annual Meeting

    PubMed Central

    Apolo, Andrea B.; Grossman, H. Barton; Bajorin, Dean; Steinberg, Gary; Kamat, Ashish M.

    2012-01-01

    At the 11th annual meeting of the Society of Urologic Oncology, an expert panel was convened to discuss the practical use of perioperative chemotherapy for muscle-invasive bladder cancer. The discussion was structured as a case-based debate among the panelist. The topics included: neoadjuvant chemotherapy with a focus on T2 disease, pros and cons, survival data, tolerability of cisplatin-based therapy, can we avoid radical cystectomy in complete responders, limitations and alternatives to cisplatin-based therapy, management of ‘suboptimal’ chemotherapy, residual disease after neoadjuvant chemotherapy, adjuvant chemotherapy and key aspects of radical cystectomy and lymph-node dissection in multi-modal therapy. The presentations were derived from published literature. The panelists agreed that patients with muscle-invasive bladder cancer should be managed with a multidisciplinary team including urologist and medical oncologist. Cisplatin-based neoadjuvant chemotherapy has demonstrated improved survival and should be incorporated into the management of all eligible patients with muscle-invasive bladder cancer. However, in some centers neoadjuvant chemotherapy is reserved for patients with >T2 disease or high-risk features. There are no data for the administration of non-cisplatin based neoadjuvant chemotherapy such as carboplatin-combinations. Cisplatin-ineligible patients should proceed directly to surgical extirpation with adjuvant cisplatin-based chemotherapy considered based on pathologic findings. However, the data for adjuvant chemotherapy is less compelling. As our refinement of the selection process continues we may be able to better identify subsets of patients who may be spared chemotherapy, but much work remains to be done in this arena. The current standard for muscle-invasive bladder cancer patients is cisplatin-based neoadjuvant chemotherapy followed by radical cystectomy and pelvic lymph-node dissection. PMID:23218068

  18. Palonosetron versus other 5-HT(3) receptor antagonists for prevention of chemotherapy-induced nausea and vomiting in patients with cancer on chemotherapy in a hospital outpatient setting.

    PubMed

    Balu, Sanjeev; Buchner, Deborah; Craver, Chris; Gayle, Julie

    2011-04-01

    Despite favorable evidence from clinical trials for single-dose palonosetron versus other commercially available 5-HT(3)-receptor antagonists for the prophylaxis of chemotherapy-induced nausea and vomiting (CINV), clinical comparative data are scarce from hospital outpatient settings, where these antiemetic agents are used in patients diagnosed with cancer who are receiving chemotherapy (CTH). The purpose of our retrospective study was to assess the hospital claims to evaluate the rate of uncontrolled CINV with antiemetic prophylaxis using palonosetron versus other 5-HT(3)-receptor antagonists in patients diagnosed with cancer who are receiving CTH (highly emetogenic CTH, moderately emetogenic CTH, low-emetogenic CTH, or minimally emetogenic CTH) treatment in a hospital outpatient setting. Patients aged ≥18 years who had cancer and were being treated with CTH and antiemetic prophylaxis with palonosetron (Group 1) and other 5-HT(3) receptor antagonists (Group 2) for the first time between April 1, 2007, and March 31, 2009, were identified using a hospital-service database. Within each CTH cycle, CINV events were identified through International Classification of Diseases (ICD)-9 codes for nausea, vomiting, and/or volume depletion (from Day 1 of each CTH administration until the end of the CTH cycle) or for use of rescue medications (Day 2 until the end of the CTH cycle). A multivariate regression model was developed to predict uncontrolled CINV event rates per CTH cycle between Groups 1 and 2 matched on CTH emetogenicity distribution in the study follow-up period (first of 8 cycles or 6 months). A subgroup analysis of patients on CTH with the highest risk of nausea and vomiting (highly emetogenic CTH or moderately emetogenic CTH) was also conducted. Of 9144 identified patients, 1775 were prescribed palonosetron (Group 1). Group 1 patients were statistically younger (61.2 vs 62.8 years; P < 0.001), composed of more females (57.1% vs 51.9%; P < 0.001) and more

  19. [Incidence and treatment of chemotherapy-induced nausea and emesis in gastrointestinal cancer].

    PubMed

    Lorenzen, S; Spörl, S; Lordick, F

    2014-08-01

    The incidence of gastrointestinal (GI) cancer is increasing, with approximately 2 million new cases diagnosed worldwide and about 1.2 million patients dying per year. In Europe, about 500 ,000 people per year are newly diagnosed with GI cancer. The most frequent cancer types that undergo chemotherapy include cancer of the oesophagus, stomach, pancreas, biliary tract and colorectum. In the last years, various new agents and combinations have been demonstrated to improve the prognosis of patients with GI cancer. However, with the introduction of new and more effective systemic treatments, the need for supportive treatment has become more complex. There has been significant improvement in the management of nausea and vomiting arising from highly and moderately emetogenic chemotherapy. Nevertheless, vomiting and especially nausea continue to be two of the most distressing side effects of antineoplastic treatment. For the prevention of chemotherapy-induced nausea and vomiting in highly emetogenic therapy, a triple therapy including a 5-HT3-receptor antagonist (RA), dexamethasone and an NK1-RA, aprepitant or fosaprepitant are recommended. In moderately emetogenic regimens, updated guidelines recommend the combination of the second-generation 5-HT3-RA palonosetron with dexamethasone, providing improved protection against acute nausea and vomiting, and demonstrating superior prevention in the delayed phase. This review provides an update of the revised clinical guidelines for antiemetic treatment and prophylaxis in GI cancer patients receiving chemotherapy. © Georg Thieme Verlag KG Stuttgart · New York.

  20. High-Dose Chemotherapy and Autologous Peripheral-Blood Stem-Cell Transplantation for Relapsed Metastatic Germ Cell Tumors: The Indiana University Experience.

    PubMed

    Adra, Nabil; Abonour, Rafat; Althouse, Sandra K; Albany, Costantine; Hanna, Nasser H; Einhorn, Lawrence H

    2017-04-01

    Purpose Patients with relapsed metastatic germ cell tumor (GCT) can be cured with second-line and even third-line regimens. We report survival outcomes of patients treated with high-dose chemotherapy (HDCT) and peripheral-blood stem-cell transplantation (PBSCT) at Indiana University between 2004 and 2014. Patients and Methods We conducted a retrospective analysis of 364 consecutive patients with GCT who progressed after cisplatin-based combination chemotherapy and were subsequently treated with HDCT and PBSCT. Three hundred forty-one patients received two consecutive courses of HDCT consisting of 700 mg/m(2) carboplatin and 750 mg/m(2) etoposide, each for 3 consecutive days, and each followed by PBSCT. Twenty-three patients received only a single course of HDCT because of progressive disease or toxicity. Cox proportional hazards models were used to test predictors of disease progression. Results The median age was 32 years (range, 17 to 70 years). With a median follow-up of 3.3 years, the 2-year progression-free survival (PFS) was 60% (95% CI, 55% to 65%) and the 2-year overall survival was 66% (95% CI, 60% to 70%). Three hundred three patients received HDCT as second-line therapy with a 2-year PFS of 63% (95% CI, 57% to 68%), and 61 patients received HDCT as third-line or later therapy with a 2-year PFS of 49% (95% CI, 36% to 61%). In a multivariable analysis, factors associated with disease progression included use of HDCT as third-line or later therapy, platinum-refractory disease, mediastinal primary tumor site, nonseminoma histology, intermediate- or poor-risk disease at the time of GCT diagnosis, and human chorionic gonadotropin ≥ 1,000 mIU/mL at initiation of HDCT. There were nine treatment-related deaths. Secondary leukemia developed in five patients. Conclusion This large single-institution study demonstrates that patients with relapsed metastatic GCT are curable by HDCT plus PBSCT even when used in third-line or later therapy.

  1. Anatomy-based definition of point A utilizing three-dimensional volumetric imaging approach for high-dose-rate (HDR) intracavitary brachytherapy dose prescription when treating cervical cancer using limited resources.

    PubMed

    Goyal, Manish K; Rai, D V; Kehwar, Than S; Manjhi, Jayanand; Heintz, Bret H; Shide, Kathleen L; Barker, Jerry L

    2016-11-01

    This study was designed to determine whether volumetric imaging could identify consistent alternative prescription methods to Manchester/point A when prescribing radiation dose in the treatment of cervical cancer using HDR intracavitary brachytherapy (ICBT). One hundred and twenty-five treatment plans of 25 patients treated for carcinoma of the cervix were reviewed retrospectively. Each patient received 5 fractions of HDR ICBT following initial cisplatin-based pelvic chemoradiation, and radiation dose was originally prescribed to point A (ICRU-38). The gross tumor volume (GTV) and high-risk clinical target volume (HR-CTV) were contoured in three dimensions on the CT datasets, and inferior-superior, anterior-posterior, and left-right dimensions HR-CTV were recorded along with multiple anatomic and skeletal dimensions for each patient. The least square-best fit regression lines were plotted between one half of the HR-CTV width and pelvic cavity dimension at femoral head level and at maximum cavity dimension. The points in both plots lie reasonably close to straight lines and are well defined by straight lines with slopes of 0.15 and 0.17; intercept on y-axes of -0.08 and -0.03, point A, at the same level as defined based on applicator coordinates, is defined using this correlation, which is a function of distance between femoral heads/dimensions of maximum pelvic cavity width. Both relations, defined by straight lines, provide an estimated location of point A, which provides adequate coverage to the HR-CTV compared to the point A defined based on applicator coordinates. The point A defined based on femoral head distance would, therefore, be a reasonable surrogate to use for dose prescription because of subjective variation of cavity width dimension. Simple surrogate anatomic/skeletal landmarks can be useful for prescribing radiation dose when treating cervical cancer using intracavitary brachytherapy in limited-resource settings. Our ongoing work will continue to

  2. Planning High-Tech High.

    ERIC Educational Resources Information Center

    Hymon, Steve

    1997-01-01

    Examines the planning process for developing a high-tech high school using the example of one such school in Florida's Collier County school district. Addresses budget figures, planning objectives, organizational considerations, pilot program creation, and planning tips. (GR)

  3. High PRF high current switch

    DOEpatents

    Moran, Stuart L.; Hutcherson, R. Kenneth

    1990-03-27

    A triggerable, high voltage, high current, spark gap switch for use in pu power systems. The device comprises a pair of electrodes in a high pressure hydrogen environment that is triggered by introducing an arc between one electrode and a trigger pin. Unusually high repetition rates may be obtained by undervolting the switch, i.e., operating the trigger at voltages much below the self-breakdown voltage of the device.

  4. High Schools.

    ERIC Educational Resources Information Center

    Educational Facility Planner, 2002

    2002-01-01

    Describes the building designs of 28 high schools, including their educational contexts and design goals. Includes information on size, construction costs, architects, and contractors. Also includes floor plans and photographs. (EV)

  5. High arch

    MedlinePlus

    ... condition can make it difficult to fit into shoes. People who have high arches most often need ... Symptoms include: Shortened foot length Difficulty fitting shoes Foot pain with walking, standing, and running (not everyone has this symptom)

  6. High Class

    ERIC Educational Resources Information Center

    Waldecker, Mark

    2005-01-01

    Education administrators make buying decisions for furniture based on many factors. Cost, durability, functionality, safety and aesthetics represent just a few. Those issues always will be important, but gaining greater recognition in recent years has been the role furniture plays in creating positive, high-performance learning environments. The…

  7. High Stakes

    ERIC Educational Resources Information Center

    Elgin, Catherine Z.

    2004-01-01

    I discuss the contributions of Harvey Siegel, Francis Schrag and Randall Curren to this volume. Their articles cast in bold relief the relation of High Stakes Testing to the goals of education, the nature of mind and the demands of justice. I argue that the connections are deep, but that the considerations these authors raise do not show that High…

  8. Low doses of haloperidol combined with ondansetron are not effective for prophylaxis of postoperative nausea and vomiting in susceptible patients.

    PubMed

    Veiga-Gil, Leonor; López-Olaondo, Luis; Pueyo, Javier; Callejas, Raquel; Duque, Paula; Carrascosa, Francisco

    2015-02-01

    In this observational study we reviewed the efficacy and side effects of different antiemetic combinations used in our hospital for postoperative nausea and vomiting (PONV) prophylaxis in high-risk women undergoing highly emetogenic surgery. After reviewing retrospectively the medical records of patients undergoing highly emetogenic elective surgeries under general anaesthesia, we selected 368 women whose Apfel risk score was ≥ 3 and receiving a combination of 2 antiemetics for PONV prophylaxis. We analysed the incidence of PONV at 2, 6, 12 and 24h after surgery, antiemetic rescue requirements, pattern of occurrence of PONV, side effects and level of sedation were also assessed. The main goal was complete response defined as no PONV within 24h after surgery. Ondansetron 4mg i.v. plus dexamethasone 8mg i.v. (O&Dex), haloperidol 1mg i.v. (O&Hal1), haloperidol 2mg i.v. (O&Hal2) or droperidol 1.25mg i.v. (O&Dro) were the combinations most frequently used. The complete response was better in groups O&Dex: 68.5% (CI: 58-78), O&Hal2: 64.1% (CI: 53-74) and O&Dro 63% (CI: 52-73) than in group O&Hal1: 41.3% (CI: 31-52) (p<0,01). Peak incidence of PONV occurred within the 2-6h period. The incidence of side effects was higher in group O&Hal2. In high risk patients for PONV who underwent highly emetogenic surgeries, the efficacy of low-dose haloperidol (1mg) in combination is limited. Higher doses (2mg) are more effective but its use is associated with a high incidence of side effects. Copyright © 2013 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  9. Computational prediction of state anxiety in Asian patients with cancer susceptible to chemotherapy-induced nausea and vomiting.

    PubMed

    Yap, Kevin Yi-Lwern; Low, Xiu Hui; Chui, Wai Keung; Chan, Alexandre

    2012-04-01

    State anxiety, a risk factor for chemotherapy-induced nausea and vomiting (CINV), is a subjective symptom and difficult to quantify. Clinicians need appropriate anxiety measures to assess patients' risks of CINV. This study aimed to determine the anxiety characteristics that can predict CINV based on computational analysis of an objective assessment tool. A single-center, prospective, observational study was carried out between January 2007 and July 2010. Patients with breast, head and neck, and gastrointestinal cancers were recruited and treated with a variety of chemotherapy protocols and appropriate antiemetics. Chemotherapy-induced nausea and vomiting characteristics and antiemetic use were recorded using a standardized diary, whereas patients' anxiety characteristics were evaluated using the Beck Anxiety Inventory. Principal component (PC) analysis was performed to analyze the anxiety characteristics. A subset known as principal variables, which had the highest PC weightings, was identified for patients with and without complete response, complete protection, and complete control. Chemotherapy-induced nausea and vomiting events and anxiety characteristics of 710 patients were collated; 51%, 30%, and 20% were on anthracycline-, oxaliplatin-, and cisplatin-based therapies, respectively. Most patients suffered from delayed CINV, with decreasing proportions achieving complete response (58%), complete protection (42%), and complete control (27%). Seven symptoms (fear of dying, fear of the worst, unable to relax, hot/cold sweats, nervousness, faintness, numbness) were identified as potential CINV predictors. This study demonstrates the usefulness of PC analysis, an unsupervised machine learning technique, to identify 7 anxiety characteristics that are useful as clinical CINV predictors. Clinicians should be aware of these characteristics when assessing CINV in patients on emetogenic chemotherapies.

  10. Cancer and chemotherapy-induced nausea and vomiting: a focus on olanzapine.

    PubMed

    Bosnjak, Snezana M; Dimitrijevic, Jelena; Djordjevic, Fedja

    2016-06-01

    The purpose of review is to critically present the evidence supporting the use of olanzapine, an atypical antipsychotic, as an antiemetic for cancer and chemotherapy-induced nausea and vomiting (CINV). Two phase III clinical studies demonstrated superior efficacy of olanzapine in comparison with the neurokinin-1 receptor antagonists (NK1RA) for substance P (aprepitant, fosaprepitant) in the prevention of nausea after highly emetogenic chemotherapy. Olanzapine is inexpensive and the replacement of NK1RA with olanzapine can reduce the costs of the prevention of CINV. The addition of olanzapine to aprepitant-containing combination regimens for the prevention of CINV was also investigated, and has the potential to further improve the prevention of CINV after highly emetogenic chemotherapy or moderately emetogenic chemotherapy, without substantial increase in costs. In the treatment of uncontrolled ('breakthrough') CINV, olanzapine was more effective than metoclopramide. Existing clinical data also support the use of olanzapine to relieve a cluster of gastrointestinal symptoms in patients with advanced cancer (chronic nausea, vomiting, and anorexia). When used in cancer patients, olanzapine is well tolerated, with sedation being the major dose-limiting side effect. Existing data from clinical trials justify further research of the role of olanzapine in the prevention of CINV. Olanzapine may be used instead of or in addition to NK1RA in the preventive antiemetic regimens. Olanzapine-containing preventive regimens may provide better nausea control after chemotherapy. When used instead of NK1RA it may also provide substantial reduction in costs of CINV prevention. In patients with advanced cancer, olanzapine was effective against a cluster of gastrointestinal symptoms (nausea, vomiting, and anorexia). The use of olanzapine as an antiemetic for CINV, or to relieve nausea, vomiting, and anorexia in palliative care is currently off-label.

  11. [Prophylaxis of chemotherapy-induced vomiting and nausea].

    PubMed

    Tóth, Judit; Szántó, János

    2008-12-01

    Chemotherapy-induced vomiting and nausea is the most common adverse event of anticancer therapy. In different guide-lines (MASCC, NCCN, ESMO and ASCO) antiemetic prophylaxis is directed toward the emetogenic potential of the chemotherapy and the type of vomiting and nausea. Chemotherapeutic agents are classified into four emetic risk groups: high, moderate, low, and minimal. Steroids, dexamethasone, metoclopramide, cannabinoids, benzodiazepines, 5-HT3 receptor antagonists (ondansetron, granisetron, tropisetron) and a new group of antiemetics, the neurokinin1 receptor antagonists are used to prevent anticipatory, acute and delayed vomiting and nausea. This paper examines evidence-based recommendations for optimal use of antiemetics.

  12. [Treatment of testicular cancer].

    PubMed

    Droz, Jean-Pierre; Boyle, Helen; Culine, Stéphane; Fizazi, Karim; Fléchon, Aude; Massard, Christophe

    2013-12-01

    Germ-cell tumours (GCTs) are the most common type of cancer in young men. Since the late 1970s, disseminated GCT have been a paradigm for curable metastatic cancer and metastatic GCTs are highly curable with cisplatin-based chemotherapy followed by surgical resection of residual masses. Patients' prognosis is currently assessed using the International Germ-Cell Consensus Classification (IGCCC) and used to adapt the burden of chemotherapy. Approximately 20% of patients still do not achieve cure after first-line cisplatin-based chemotherapy, and need salvage chemotherapy (high dose or standard dose chemotherapy). Clinical stage I testicular cancer is the most common presentation and different strategies are proposed: adjuvant therapies, surgery or surveillance. During the last three decades, clinical trials and strong international collaborations lead to the development of a consensus in the management of GCTs.

  13. Prognostic Value of p16 Status on the Development of a Complete Response in Involved Oropharynx Cancer Neck Nodes After Cisplatin-Based Chemoradiation: A Secondary Analysis of NRG Oncology RTOG 0129

    PubMed Central

    Galloway, Thomas J.; Zhang, Qiang; Nguyen-Tan, Phuc Felix; Rosenthal, David I.; Soulieres, Denis; Fortin, André; Silverman, Craig L.; Daly, Megan E.; Ridge, John A.; Hammond, J. Alexander; Le, Quynh-Thu

    2016-01-01

    Purpose To determine the relationship between p16 status and the regional response of patients with node-positive oropharynx cancer treated on NRG Oncology RTOG 0129. Methods and Materials Patients with N1-N3 oropharynx cancer and known p16 status who underwent treatment on RTOG 0129 were analyzed. Pathologic complete response (pCR) rates in patients treated with a postchemoradiation neck dissection (with p16-positive or p16-negative cancer) were compared by Fisher exact test. Patients managed expectantly were compared with those treated with a neck dissection. Results Ninety-nine (34%) of 292 patients with node-positive oropharynx cancer and known p16 status underwent a posttreatment neck dissection (p16-positive: n = 69; p16-negative: n = 30). The remaining 193 patients with malignant lymphadenopathy at diagnosis were observed. Neck dissection was performed a median of 70 (range, 17-169) days after completion of chemoradiation. Neither the pretreatment nodal stage (P = .71) nor the postradiation, pre-neck dissection clinical/radiographic neck assessment (P = .42) differed by p16 status. A pCR was more common among p16-positive patients (78%) than p16-negative patients (53%, P = .02) and was associated with a reduced incidence of local–regional failure (hazard ratio 0.33, P = .003). On multivariate analysis of local–regional failure, a test for interaction between pCR and p16 status was not significant (P = .37). One-hundred ninety-three (66%) of 292 of initially node-positive patients were managed without a posttreatment neck dissection. Development of a clinical (cCR) was not significantly influenced by p16-status (P = .42). Observed patients with a clinical nodal CR had disease control outcomes similar to those in patients with a pCR neck dissection. Conclusions Patients with p16-positive tumors had significantly higher pCR and locoregional control rates than those with p16-negative tumors. PMID:27478170

  14. Prognostic Value of p16 Status on the Development of a Complete Response in Involved Oropharynx Cancer Neck Nodes After Cisplatin-Based Chemoradiation: A Secondary Analysis of NRG Oncology RTOG 0129.

    PubMed

    Galloway, Thomas J; Zhang, Qiang Ed; Nguyen-Tan, Phuc Felix; Rosenthal, David I; Soulieres, Denis; Fortin, André; Silverman, Craig L; Daly, Megan E; Ridge, John A; Hammond, J Alexander; Le, Quynh-Thu

    2016-10-01

    To determine the relationship between p16 status and the regional response of patients with node-positive oropharynx cancer treated on NRG Oncology RTOG 0129. Patients with N1-N3 oropharynx cancer and known p16 status who underwent treatment on RTOG 0129 were analyzed. Pathologic complete response (pCR) rates in patients treated with a postchemoradiation neck dissection (with p16-positive or p16-negative cancer) were compared by Fisher exact test. Patients managed expectantly were compared with those treated with a neck dissection. Ninety-nine (34%) of 292 patients with node-positive oropharynx cancer and known p16 status underwent a posttreatment neck dissection (p16-positive: n=69; p16-negative: n=30). The remaining 193 patients with malignant lymphadenopathy at diagnosis were observed. Neck dissection was performed a median of 70 (range, 17-169) days after completion of chemoradiation. Neither the pretreatment nodal stage (P=.71) nor the postradiation, pre-neck dissection clinical/radiographic neck assessment (P=.42) differed by p16 status. A pCR was more common among p16-positive patients (78%) than p16-negative patients (53%, P=.02) and was associated with a reduced incidence of local-regional failure (hazard ratio 0.33, P=.003). On multivariate analysis of local-regional failure, a test for interaction between pCR and p16 status was not significant (P=.37). One-hundred ninety-three (66%) of 292 of initially node-positive patients were managed without a posttreatment neck dissection. Development of a clinical (cCR) was not significantly influenced by p16-status (P=.42). Observed patients with a clinical nodal CR had disease control outcomes similar to those in patients with a pCR neck dissection. Patients with p16-positive tumors had significantly higher pCR and locoregional control rates than those with p16-negative tumors. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Addition of 3-day aprepitant to ondansetron and dexamethasone for prophylaxis of chemotherapy-induced nausea and vomiting among patients with diffuse large B cell lymphoma receiving 5-day cisplatin-based chemotherapy.

    PubMed

    Abdel-Malek, Raafat; Abbas, Noha; Shohdy, Kyrillus S; Ismail, Mohamed; Fawzy, Radwa; Salem, Dalal S; Safwat, Ezzat

    2017-09-01

    Neurokinin-1 receptor antagonists, such as aprepitant are currently emerging as powerful prophylactic agents for chemotherapy-induced nausea and vomiting (CINV). Therefore, it is important to adjust the anti-emetic regimens based on personal risk factors of the patient, duration of the chemotherapy regimen and cost-effectiveness. To determine the efficacy of the 3-day aprepitant along with ondansetron and dexamethasone in controlling CINV in patients with large B cell lymphoma receiving multiday-cisplatin regimen chemotherapy. This is a pilot prospective cross-over trial. Patients were allocated to either aprepitant 125mg on day 1 and 80mg on days 2 & 3 or placebo in the first 2 cycles, with crossover to the opposite treatment in the 3rd and 4th cycles. The primary end point was complete response (CR) of both acute (days 1-5) and delayed (days 6-8) CINV. CR means neither to develop emetic episodes nor to use rescue anti-emetics medication. Twelve of the 15 patients recruited for the study were fully evaluable and completed 4 cycles of ESHAP regimen with a total of 48 cycles given. In the cycles with aprepitant and those without the CR were 83.3% and 0% respectively (p<0.05). Patients receiving aprepitant in the first 2 cycles recorded less nausea in subsequent cycles that were given without aprepitant. This was not statistically significant. This triple anti-emetic regimen showed efficacy in controlling the multi-day cisplatin-induced nausea and vomiting. Further randomized controlled trials are needed to compare between 3-day and 7-day aprepitant for multi-day cisplatin regimens. Copyright © 2017. Production and hosting by Elsevier B.V.

  16. [Analysis of the effectiveness of an antiemetic protocol used in an oncology division].

    PubMed

    Huertas-Fernández, M J; Martínez-Bautista, M J; Sánchez-Martínez, I; Zarzuela-Ramírez, M; Baena-Cañada, J M

    2010-01-01

    To analyse the effectiveness of an antiemetic protocol in patients receiving chemotherapy treatment. Prospective study in patients with solid tumours receiving chemotherapy in an oncology day hospital between January 2006 and 2007. We conducted a literature review and an evaluation of the recommendations of different clinical practice guidelines. The emetogenic potential was calculated according to the Hesketh level (HL), and the antiemetic premedication was determined for each regimen. We evaluated the effectiveness of an antiemetic protocol by using a survey as a method for measuring emetic episodes and nausea in the acute and delayed phases. 172 patients completed the survey. 13.4% vomited in the acute phase and 16.9% in the delayed phase; the median number of times was 2 (1-8) and 1 (1-5) for each respective phase. With treatment regimens classed as HL 4-5, 18.5% experienced vomiting in the acute phase and 20.2% in the delayed phase, with 46% experiencing nausea in the acute phase and 38.4% in the delayed phase. Control of vomiting in patients with treatment regimens classed as HL 1-3 was 100% in acute phase and 91.7% in the delayed phase; nausea was reported by 27% in the acute phase and 31% in the delayed phase. The factors that contributed the most to the presence of vomiting and nausea were the emetogenic potential of the treatment regimen (p<0.05), vomiting in the previous cycle (p<0.05) and age younger than 50 years (p<0.002). The proposed antiemetic protocol is effective for controlling vomiting in chemotherapy regimens with an HL of 1-3. For highly emetogenic regimens, the antiemetic protocol is also effective, but protection is not complete. This protocol seems less effective for controlling nausea, although this is a subjective symptom which is difficult to assess and not routinely measured in clinical trials. Copyright © 2009 SEFH. Published by Elsevier Espana. All rights reserved.

  17. Review of the efficacy of aprepitant for the prevention of chemotherapy-induced nausea and vomiting in a range of tumor types.

    PubMed

    Aapro, Matti S; Schmoll, Hans J; Jahn, Franziska; Carides, Alexandra D; Webb, R Timothy

    2013-02-01

    Chemotherapy regimens differ according to the tumor type being treated and are associated with varying degrees of emetogenic potential. Since the distribution of risk factors for chemotherapy-induced nausea and vomiting differs across tumor types, it is important to understand the efficacy of antiemetic regimens in multiple patient populations. To characterize treatment response in patients with various malignancies (e.g., breast, gastrointestinal, genitourinary, and lung) treated with either highly emetogenic chemotherapy (HEC) or moderately emetogenic chemotherapy (MEC) regimens, a pooled analysis of patient-level data from 4 large randomized trials was performed (N=2813). Patients receiving an antiemetic regimen containing aprepitant, ondansetron, and dexamethasone were compared with patients receiving an active-control antiemetic regimen containing ondansetron plus dexamethasone. In all tumor types analyzed, complete responses were observed in a higher proportion of HEC-treated patients receiving aprepitant compared with active-control patients (genitourinary [61.5% vs 40.6%, P<0.001], gastrointestinal [68.2% vs 44.7%, P=0.013], and lung cancers [73.5% vs 52.8%, P<0.001]). For MEC-treated patients, complete response rates were also higher for aprepitant patients than active-control patients for all tumor types, with a significant difference noted among patients with breast cancer (54.9% vs 43.9%, P<0.0001). The proportion of patients with no vomiting was higher in both HEC- and MEC-treated patients. While results of previous studies provide support for the use of antiemetic regimens that include aprepitant, a selective 5-hydroxytryptamine-3 receptor antagonist, and dexamethasone, this analysis demonstrates the consistent efficacy of aprepitant as part of an antiemetic regimen across different tumor types and chemotherapy regimens. Copyright © 2012 Elsevier Ltd. All rights reserved.

  18. Project Georgia High School/High Tech

    NASA Technical Reports Server (NTRS)

    2000-01-01

    Georgia High School/High Tech has been developing a suggested curriculum for use in its programs. The purpose of this instructional material is to provide a basic curriculum format for teachers of High School/High Tech students. The curriculum is designed to implement QCC classroom instruction that encourages career development in technological fields through post-secondary education, paid summer internships, and exposure to experiences in high technology.

  19. Development of fast dissolving oral film containing dexamethasone as an antiemetic medication: clinical usefulness.

    PubMed

    Nishigaki, Minako; Kawahara, Kana; Nawa, Masahito; Futamura, Manabu; Nishimura, Misao; Matsuura, Katsuhiko; Kitaichi, Kiyoyuki; Kawaguchi, Yoshihiro; Tsukioka, Tadao; Yoshida, Kazuhiro; Itoh, Yoshinori

    2012-03-15

    We developed a fast dissolving oral film containing 4 mg dexamethasone and examined the clinical effect of the film as the antiemetic by a randomized controlled crossover study in breast cancer patients receiving a combination chemotherapy with anthracycline and cyclophosphamide, a highly emetogenic chemotherapy. The film was prepared as reported previously using microcrystalline cellulose, polyethylene glycol, hypromellose, polysorbate 80 and 5% low substituted hydroxypropylcellulose as base materials. The uniformity of the film was shown by the relative standard deviation of 2.7% and acceptance value of 5.9% by the Japanese Pharmacopoeia. Patients were administered with 8 mg dexamethasone as oral film or tablet on days 2-4 after chemotherapy in addition to the standard antiemetic medication. The rates of complete protection from vomiting during acute and delayed phases were not different between film-treated group and tablet-treated group. The time course of the complete protection from nausea or vomiting during 0-120 h was also similar between the two groups. Patient's impressions on the oral acceptability in respect of the taste and ease in taking were significantly better for film than for tablet. Therefore, the present fast dissolving oral film containing dexamethasone seems to be potentially useful as an antiemetic agent in patients receiving highly emetogenic chemotherapy.

  20. Differential clinical pharmacology of rolapitant in delayed chemotherapy-induced nausea and vomiting (CINV)

    PubMed Central

    Rashad, Noha; Abdel-Rahman, Omar

    2017-01-01

    Rolapitant is a highly selective neurokinin-1 receptor antagonist, orally administered for a single dose of 180 mg before chemotherapy with granisetron D1, dexamethasone 8 mg BID on day 2–4. It has a unique pharmacological characteristic of a long plasma half-life (between 163 and 183 hours); this long half-life makes a single use sufficient to cover the delayed emesis risk period. No major drug–drug interactions between rolapitant and dexamethasone or other cytochrome P450 inducers or inhibitors were observed. The clinical efficacy of rolapitant was studied in two phase III trials in highly emetogenic chemotherapy and in one clinical trial in moderately emetogenic chemotherapy. The primary endpoint was the proportion of patients achieving a complete response (defined as no emesis or use of rescue medication) in the delayed phase (>24–120 hours after chemotherapy). In comparison to granisetron (10 μg/kg intravenously) and dexamethasone (20 mg orally) on day 1, and dexamethasone (8 mg orally) twice daily on days 2–4 and placebo, rolapitant showed superior efficacy in the control of delayed and overall emesis. This review aims at revising the pharmacological characteristics of rolapitant, offering an updated review of the available clinical efficacy and safety data of rolapitant in different clinical settings, highlighting the place of rolapitant in the management of chemotherapy-induced nausea and vomiting (CINV) among currently available guidelines, and exploring the future directions of CINV management. PMID:28392676

  1. Chemotherapy-induced nausea and vomiting: the importance of acute antiemetic control.

    PubMed

    Schnell, Frederick M

    2003-01-01

    Nausea and vomiting are two of the most feared side effects of cancer chemotherapy and radiotherapy. Chemotherapy-induced nausea and vomiting can be broadly categorized as acute (occurring within 24 hours of therapy), delayed (persisting for 6-7 days after therapy), or anticipatory (occurring prior to chemotherapy administration). Breakthrough and refractory nausea and vomiting describe the symptoms of uncontrolled emesis. Evidence suggests that good control of nausea and vomiting during the acute period correlates with the control of delayed emesis. Conversely, protection failure during the first 24 hours has a high predictive value for delayed emesis in the same cycle. The 5-HT(3)-receptor antagonists, regarded as the 'gold standard' in antiemetic therapy, are the first-line treatment for moderately and highly emetogenic chemotherapy and radiotherapy regimens in adults and children. Evidence suggests that the 5-HT(3)-receptor antagonists administered in combination with corticosteroids afford the best protection from symptoms of acute emesis and, by extrapolation, the most effective prevention of delayed emesis. Antiemetic therapeutic guidelines stress that the goal of therapy is to prevent cytostatic-induced nausea and vomiting. Therefore, the prophylactic use of the most effective antiemetic regimen-taking into consideration the emetogenicity of the chemotherapy and individual patient characteristics-must be adhered to in order to prevent acute, delayed, and anticipatory nausea and vomiting.

  2. High power, high frequency component test facility

    NASA Technical Reports Server (NTRS)

    Roth, Mary Ellen; Krawczonek, Walter

    1990-01-01

    The NASA Lewis Research Center has available a high frequency, high power laboratory facility for testing various components of aerospace and/or terrestrial power systems. This facility is described here. All of its capabilities and potential applications are detailed.

  3. Improved control of nausea and emesis with a new bromazepam-containing ondansetron regimen in ovarian cancer patients receiving chemotherapy with carboplatin and cyclophosphamide.

    PubMed

    Meden, H; Meissner, O; Conrad, A; Kuhn, W

    1996-01-01

    Ondansetron was found to be effective as an antiemetic in numerous clinical trials of highly emetogenic combination-chemotherapy regimens that included cisplatin. Its role in milder emetogenic regimes has not been fully defined. This study investigated the efficacy of two different antiemetic regimes in thirty-five patients with ovarian cancer receiving 68 cycles of chemotherapy with carboplatin (350 mg/m2) and cyclophosphamide (600 mg/m2). Ondansetron (3 x 8 mg i.v.) was compared to a bromazepam-containing ondansetron regimen. Nausea was absent in 65% of chemotherapy courses in patients receiving the combination of ondansetron and bromazepam and in 38% of chemotherapy courses in patients receiving ondansetron alone. Complete control of emesis was achieved in 93% of the courses in patients receiving the combination and in 81% of the courses using ondansetron alone. The addition of bromazepam to ondansetron, and the extension of antiemetic prophylaxis to the day before and the day after chemotherapy improves the control of nausea and emesis compared to ondansetron monotherapy in patients with ovarian cancer.

  4. Differential pharmacology and clinical utility of rolapitant in chemotherapy-induced nausea and vomiting

    PubMed Central

    Rapoport, Bernardo Leon

    2017-01-01

    Chemotherapy-induced nausea and vomiting (CINV) is a debilitating side effect of many cytotoxic chemotherapy regimens. CINV typically manifests during two well-defined time periods (acute and delayed phases). The acute phase is the first 24 hours after chemotherapy and is largely managed with 5-hydroxytryptamine 3 receptor antagonists. The delayed phase, a 5-day at-risk period during which patients are not often in direct contact with their health care provider, remains a significant unmet medical need. Neurokinin-1 (NK-1) receptor antagonists have demonstrated protection against acute and delayed CINV in patients treated with highly emetogenic chemotherapy and moderately emetogenic chemotherapy when used in combination with a 5-hydroxytryptamine 3 receptor antagonist and dexamethasone. Furthermore, recent data indicate that this protection is maintained over multiple treatment cycles. Rolapitant, a selective and long-acting NK-1 receptor antagonist, is approved as oral formulation for the prevention of delayed CINV in adults. This review discusses the differential pharmacology and clinical utility of rolapitant in preventing CINV compared with other NK-1 receptor antagonists. PMID:28260945

  5. Aprepitant: a review of its use in the prevention of nausea and vomiting.

    PubMed

    Curran, Monique P; Robinson, Dean M

    2009-01-01

    Aprepitant (Emend) is a neurokinin-1 (NK(1)) receptor antagonist that is able to alleviate the emetic effects of substance P. When combined with a standard regimen of a corticosteroid (dexamethasone) and a serotonin 5-HT(3) receptor antagonist (ondansetron), oral aprepitant (125 mg on day 1 then 80 mg once daily on days 2 and 3) was effective in the prevention of acute and delayed chemotherapy-induced nausea and vomiting (CINV) associated with single or multiple cycles of highly emetogenic chemotherapy (HEC). This aprepitant regimen was also effective in the prevention of CINV in patients treated with single or multiple cycles of moderately emetogenic chemotherapy (MEC). A single oral dose of aprepitant 40 mg administered prior to patients undergoing abdominal surgery was also effective in the prevention of postoperative nausea and vomiting (PONV). Aprepitant was generally well tolerated. Aprepitant is a recommended option for the treatment of PONV, and when combined with a corticosteroid and 5-HT(3) receptor antagonist is a recommended regimen for the treatment of CINV.

  6. Olanzapine for chemotherapy-induced nausea and vomiting: a systematic review.

    PubMed

    Hocking, Christopher M; Kichenadasse, Ganessan

    2014-04-01

    Newer drugs incorporated in prophylactic regimens for chemotherapy-induced nausea and vomiting (CINV) have resulted in significantly reduced rates of this feared complication of cytotoxic chemotherapy. However, both delayed chemotherapy-induced nausea and breakthrough CINV remain difficult areas of management and require novel treatment strategies. Recent randomized trial evidence has suggested that olanzapine, an atypical antipsychotic, may have a role in both the prevention and treatment of CINV. A systematic review was conducted to assess the efficacy of olanzapine in (a) preventing CINV in highly emetogenic chemotherapy (HEC) and moderately emetogenic chemotherapy (MEC) and (b) the treatment of breakthrough CINV. The toxicity of olanzapine in this setting was also reviewed. MEDLINE, Embase and Cochrane Database of Systematic Reviews databases were searched to identify all randomized clinical trials (RCTs) investigating olanzapine in patients receiving chemotherapy. A total of 488 patients from three trials of CINV prophylaxis and 323 patients from three trials of breakthrough CINV were included. Regimens including olanzapine were associated with significant improvements in CINV prevention with both HEC and MEC. Single agent olanzapine for breakthrough nausea was superior to standard alternative options. Data from RCTs support the use of an olanzapine containing combination regimen as an option for CINV prophylaxis and single agent olanzapine for the treatment of breakthrough CINV. In the included trials, the short duration of olanzapine appears safe and well tolerated.

  7. Palonosetron for the treatment of chemotherapy-induced nausea and vomiting.

    PubMed

    Navari, Rudolph M

    2014-12-01

    Chemotherapy-induced nausea and vomiting (CINV) is associated with a significant deterioration in quality of life. The emetogenicity of the chemotherapeutic agents, repeated chemotherapy cycles, and patient risk factors significantly influence CINV. The introduction of 5-hydroxytryptamine-3 (5-HT3) receptor antagonists has been a major factor in the improvement of the prevention of chemotherapy-induced acute and delayed emesis. Palonosetron , a second-generation 5-HT3 receptor antagonist with a different half-life, a different binding capacity, and a different mechanism of action than the first-generation 5-HT3 receptor antagonists appears to be the most effective agent in this drug class. Palonosetron's chemistry, pharmacodynamics, pharmacokinetics, metabolism, clinical efficacy, including comparison with other antiemetics, role in controlling nausea, potential role in multi-day chemotherapy and bone marrow transplantation, and overall safety are discussed. The clinical data in the literature have established palonosetron as the 5-HT3 receptor antagonist of choice in terms of efficacy and safety for the prevention of CINV for patients receiving moderately or highly emetogenic chemotherapy. Three international guidelines have listed palonosetron as the preferred 5-HT3 receptor antagonist. Due to its higher efficacy, the use of palonosetron may be more cost effective compared to the generic first-generation 5-HT3 receptor antagonists. Clinical organizations' pharmacy and formulary committees should consider efficacy when making recommendations for agents for the prevention of CINV.

  8. Granisetron Extended-Release Injection: A Review in Chemotherapy-Induced Nausea and Vomiting.

    PubMed

    Deeks, Emma D

    2016-12-01

    An extended-release (ER) subcutaneously injectable formulation of the first-generation 5-HT3 receptor antagonist granisetron is now available in the USA (Sustol(®)), where it is indicated for the prevention of acute and delayed chemotherapy-induced nausea and vomiting (CINV) following moderately emetogenic chemotherapy (MEC) or anthracycline and cyclophosphamide combination chemotherapy regimens in adults. Granisetron ER is administered as a single subcutaneous injection and uses an erosion-controlled drug-delivery system to allow prolonged granisetron release. Primary endpoint data from phase III studies after an initial cycle of chemotherapy indicate that, when used as part of an antiemetic regimen, granisetron ER injection is more effective than intravenous ondansetron in preventing delayed CINV following highly emetogenic chemotherapy (HEC); is noninferior to intravenous palonosetron in preventing both acute CINV following MEC or HEC and delayed CINV following MEC; and is similar, but not superior, to palonosetron in preventing delayed CINV following HEC. The benefits of granisetron ER were seen in various patient subgroups, including those receiving anthracycline plus cyclophosphamide-based HEC, and (in an extension of one of the studies) over multiple MEC or HEC cycles. Granisetron ER injection is generally well tolerated, with an adverse event profile similar to that of ondansetron or palonosetron. Thus, granisetron ER injection expands the options for preventing both acute and delayed CINV in adults with cancer receiving MEC or anthracycline plus cyclophosphamide-based HEC.

  9. Aprepitant for the prevention of chemotherapy-induced nausea and vomiting in children: a randomised, double-blind, phase 3 trial.

    PubMed

    Kang, Hyoung Jin; Loftus, Susan; Taylor, Arlene; DiCristina, Cara; Green, Stuart; Zwaan, Christian Michel

    2015-04-01

    Oral aprepitant, a neurokinin-1 receptor antagonist, is recommended in combination with other anti-emetic agents for the prevention of nausea and vomiting associated with moderately or highly emetogenic chemotherapy in adults, but its efficacy and safety in paediatric patients are unknown. We did this phase 3 trial to examine the safety and efficacy of such treatment in children. In this final analysis of a phase 3, randomised, multicentre, double-blind study, patients aged 6 months to 17 years with a documented malignancy who were scheduled to receive either moderately or highly emetogenic chemotherapy were randomly assigned with an interactive voice response system to an age-based and weight-based blinded regimen of aprepitant (125 mg for ages 12-17 years; 3·0 mg/kg up to 125 mg for ages 6 months to <12 years) plus ondansetron on day 1, followed by aprepitant (80 mg for ages 12-17 years; 2·0 mg/kg up to 80 mg for ages 6 months to <12 years) on days 2 and 3, or placebo plus ondansetron on day 1 followed by placebo on days 2 and 3; addition of dexamethasone was allowed. Randomisation was stratified according to patient age, planned use of chemotherapy associated with very high risk of emetogenicity, and planned use of dexamethasone as an anti-emetic. Ondansetron was dosed per the product label for paediatric use or local standard of care. The primary efficacy endpoint was the proportion of patients who achieved complete response (defined as no vomiting, no retching, and no use of rescue medication) during the 25-120 h (delayed phase) after initiation of emetogenic chemotherapy. Efficacy and safety analyses were done with all randomly assigned patients who received at least one dose of study treatment. This study is registered with ClinicalTrials.gov, number NCT01362530. Between Sept 22, 2011, and Aug 16, 2013, 307 patients were randomly assigned at 49 sites in 24 countries to either the aprepitant group (155 patients) or to the control group (152 patients). Three

  10. Project Georgia High School/High Tech

    NASA Technical Reports Server (NTRS)

    2000-01-01

    The High School/High Tech initiative of the President's Committee on Employment of Disabilities, Georgia's application of the collaborative "Georgia Model" and NASA's commitment of funding have shown that opportunities for High School/High Tech students are unlimited. In Georgia, the partnership approach to meeting the needs of this program has opened doors previously closed. As the program grows and develops, reflecting the needs of our students and the marketplace, more opportunities will be available. Our collaboratives are there to provide these opportunities and meet the challenge of matching our students with appropriate education and career goals. Summing up the activities and outcomes of Project Georgia High School/High Tech is not difficult. Significant outcomes have already occurred in the Savannah area as a result of NASA's grant. The support of NASA has enabled Georgia Committee to "grow" High School/High Tech throughout the region-and, by example, the state. The success of the Columbus pilot project has fostered the proliferation of projects, resulting in more than 30 Georgia High School High Tech programs-with eight in the Savannah area.

  11. High Blood Pressure

    MedlinePlus

    ... version of this page please turn Javascript on. High Blood Pressure What Is High Blood Pressure? High blood pressure is a common disease in ... the heart, kidneys, brain, and eyes. Types of High Blood Pressure There are two main types of high blood ...

  12. High Blood Pressure

    MedlinePlus

    ... normal blood pressure 140/90 or higher is high blood pressure Between 120 and 139 for the top number, ... prehypertension. Prehypertension means you may end up with high blood pressure, unless you take steps to prevent it. High ...

  13. High Blood Pressure (Hypertension)

    MedlinePlus

    ... Print Page Text Size: A A A Listen High Blood Pressure (Hypertension) Nearly 1 in 3 American adults has ... weight. How Will I Know if I Have High Blood Pressure? High blood pressure is a silent problem — you ...

  14. High strength high modulus ceramic fiber

    NASA Technical Reports Server (NTRS)

    Fetterolf, R. N.

    1972-01-01

    Low cost method was developed for producing high strength, high modulus, continuous ceramic oxide fibers. Process transforms inexpensive metallic salts into syrup-like liquids that can be fiberized at room temperatures. Resulting salt fibers are then converted to oxides by calcination at relatively low temperatures.

  15. High-Flying High-Poverty Schools

    ERIC Educational Resources Information Center

    American Educator, 2013

    2013-01-01

    In discussing socioeconomic integration before audiences, the author is frequently asked: What about high-poverty schools that do work? Don't they suggest that economic segregation isn't much of a problem after all? High-poverty public schools that beat the odds paint a heartening story that often attracts considerable media attention. In 2000,…

  16. Bringing the High Court to High School.

    ERIC Educational Resources Information Center

    Raskin, Jamin B.

    2002-01-01

    Describes the Marshall-Brennan Fellowship constitutional literacy project wherein 30 pairs of law students at the Washington College of Law teach a constitutional rights and responsibilities course to high school students in Washington, D.C., and Maryland public high schools. Students are also taken to hear oral arguments at the Supreme Court.…

  17. High speed, high current pulsed driver circuit

    DOEpatents

    Carlen, Christopher R.

    2017-03-21

    Various technologies presented herein relate to driving a LED such that the LED emits short duration pulses of light. This is accomplished by driving the LED with short duration, high amplitude current pulses. When the LED is driven by short duration, high amplitude current pulses, the LED emits light at a greater amplitude compared to when the LED is driven by continuous wave current.

  18. High Performance Networks for High Impact Science

    SciTech Connect

    Scott, Mary A.; Bair, Raymond A.

    2003-02-13

    This workshop was the first major activity in developing a strategic plan for high-performance networking in the Office of Science. Held August 13 through 15, 2002, it brought together a selection of end users, especially representing the emerging, high-visibility initiatives, and network visionaries to identify opportunities and begin defining the path forward.

  19. Development of high strength, high temperature ceramics

    NASA Technical Reports Server (NTRS)

    Hall, W. B.

    1982-01-01

    Improvement in the high-pressure turbopumps, both fuel and oxidizer, in the Space Shuttle main engine were considered. The operation of these pumps is limited by temperature restrictions of the metallic components used in these pumps. Ceramic materials that retain strength at high temperatures and appear to be promising candidates for use as turbine blades and impellers are discussed. These high strength materials are sensitive to many related processing parameters such as impurities, sintering aids, reaction aids, particle size, processing temperature, and post thermal treatment. The specific objectives of the study were to: (1) identify and define the processing parameters that affect the properties of Si3N4 ceramic materials, (2) design and assembly equipment required for processing high strength ceramics, (3) design and assemble test apparatus for evaluating the high temperature properties of Si3N4, and (4) conduct a research program of manufacturing and evaluating Si3N4 materials as applicable to rocket engine applications.

  20. High pressure, high current, low inductance, high reliability sealed terminals

    DOEpatents

    Hsu, John S [Oak Ridge, TN; McKeever, John W [Oak Ridge, TN

    2010-03-23

    The invention is a terminal assembly having a casing with at least one delivery tapered-cone conductor and at least one return tapered-cone conductor routed there-through. The delivery and return tapered-cone conductors are electrically isolated from each other and positioned in the annuluses of ordered concentric cones at an off-normal angle. The tapered cone conductor service can be AC phase conductors and DC link conductors. The center core has at least one service conduit of gate signal leads, diagnostic signal wires, and refrigerant tubing routed there-through. A seal material is in direct contact with the casing inner surface, the tapered-cone conductors, and the service conduits thereby hermetically filling the interstitial space in the casing interior core and center core. The assembly provides simultaneous high-current, high-pressure, low-inductance, and high-reliability service.

  1. High-field/high-pressure ESR

    NASA Astrophysics Data System (ADS)

    Sakurai, T.; Okubo, S.; Ohta, H.

    2017-07-01

    We present a historical review of high-pressure ESR systems with emphasis on our recent development of a high-pressure, high-field, multi-frequency ESR system. Until 2000, the X-band system was almost established using a resonator filled with dielectric materials or a combination of the anvil cell and dielectric resonators. Recent developments have shifted from that in the low-frequency region, such as X-band, to that in multi-frequency region. High-pressure, high-field, multi-frequency ESR systems are classified into two types. First are the systems that use a vector network analyzer or a quasi-optical bridge, which have high sensitivity but a limited frequency region; the second are like our system, which has a very broad frequency region covering the THz region, but lower sensitivity. We will demonstrate the usefulness of our high-pressure ESR system, in addition to its experimental limitations. We also discuss the recent progress of our system and future plans.

  2. High speed high dynamic range high accuracy measurement system

    SciTech Connect

    Deibele, Craig E.; Curry, Douglas E.; Dickson, Richard W.; Xie, Zaipeng

    2016-11-29

    A measuring system includes an input that emulates a bandpass filter with no signal reflections. A directional coupler connected to the input passes the filtered input to electrically isolated measuring circuits. Each of the measuring circuits includes an amplifier that amplifies the signal through logarithmic functions. The output of the measuring system is an accurate high dynamic range measurement.

  3. Bumball: Highly Engaging, Highly Inclusive, and Highly Entertaining

    ERIC Educational Resources Information Center

    Hall, Amber; Barney, David; Wilkinson, Carol

    2014-01-01

    Physical educators are always looking for new and exciting games and activities in which students can participate. This article describes Bumball, a high-intensity game that provides the opportunity for students to use many common game skills, such as hand-eye coordination, passing to a target, running, playing defense, and getting to an open…

  4. Bumball: Highly Engaging, Highly Inclusive, and Highly Entertaining

    ERIC Educational Resources Information Center

    Hall, Amber; Barney, David; Wilkinson, Carol

    2014-01-01

    Physical educators are always looking for new and exciting games and activities in which students can participate. This article describes Bumball, a high-intensity game that provides the opportunity for students to use many common game skills, such as hand-eye coordination, passing to a target, running, playing defense, and getting to an open…

  5. Hypertension (High Blood Pressure)

    MedlinePlus

    ... Loss Surgery? A Week of Healthy Breakfasts Shyness Hypertension (High Blood Pressure) KidsHealth > For Teens > Hypertension (High Blood Pressure) A ... rest temperature diet emotions posture medicines Why Is High Blood Pressure Bad? High blood pressure means a person's heart ...

  6. High Schools with Character.

    ERIC Educational Resources Information Center

    Hill, Paul T.; And Others

    This study compares zoned high schools, special public magnet schools, and Catholic high schools to identify features that motivate low-income students. Ten days of observations, interviews, and reviews of student records were conducted at eight New York City schools. Of the eight, three were Catholic high schools, two were zoned high schools, and…

  7. High-current, high-frequency capacitors

    NASA Astrophysics Data System (ADS)

    Renz, D. D.

    1983-06-01

    The NASA Lewis high-current, high-frequency capacitor development program was conducted under a contract with Maxwell Laboratories, Inc., San Diego, California. The program was started to develop power components for space power systems. One of the components lacking was a high-power, high-frequency capacitor. Some of the technology developed in this program may be directly usable in an all-electric airplane. The materials used in the capacitor included the following: the film is polypropylene, the impregnant is monoisopropyl biphenyl, the conductive epoxy is Emerson and Cuming Stycast 2850 KT, the foil is aluminum, the case is stainless steel (304), and the electrode is a modified copper-ceramic.

  8. High-current, high-frequency capacitors

    NASA Technical Reports Server (NTRS)

    Renz, D. D.

    1983-01-01

    The NASA Lewis high-current, high-frequency capacitor development program was conducted under a contract with Maxwell Laboratories, Inc., San Diego, California. The program was started to develop power components for space power systems. One of the components lacking was a high-power, high-frequency capacitor. Some of the technology developed in this program may be directly usable in an all-electric airplane. The materials used in the capacitor included the following: the film is polypropylene, the impregnant is monoisopropyl biphenyl, the conductive epoxy is Emerson and Cuming Stycast 2850 KT, the foil is aluminum, the case is stainless steel (304), and the electrode is a modified copper-ceramic.

  9. High strength and high toughness steel

    DOEpatents

    Parker, Earl R.; Zackay, Victor F.

    1979-01-01

    A structural steel which possess both high strength and high toughness and has particular application of cryogenic uses. The steel is produced by the utilization of thermally induced phase transformation following heating in a three-phase field in iron-rich alloys of the Fe-Ni-Ti system, with a preferred composition of 12% nickel, 0.5% titanium, the remainder being iron.

  10. High strength, high ductility low carbon steel

    DOEpatents

    Koo, Jayoung; Thomas, Gareth

    1978-01-01

    A high strength, high ductility low carbon steel consisting essentially of iron, 0.05-0.15 wt% carbon, and 1-3 wt% silicon. Minor amounts of other constituents may be present. The steel is characterized by a duplex ferrite-martensite microstructure in a fibrous morphology. The microstructure is developed by heat treatment consisting of initial austenitizing treatment followed by annealing in the (.alpha. + .gamma.) range with intermediate quenching.

  11. Space Based Infrared System High (SBIRS High)

    DTIC Science & Technology

    2015-12-01

    mission areas: Missile Warning, Missile Defense, Technical Intelligence and Battlespace Awareness. The constellation architecture for SBIRS High...2015. A formal test on December 10-18, 2015 proved the Block 10.3 system has the ability to control the full constellation (GEO/HEO and DSP) of...on the full SBIRS constellation and Ground Segment. SBIRS High December 2015 SAR March 23, 2016 11:24:26 UNCLASSIFIED 14 Block Buy (GEO 5-6) No

  12. High-power, high-efficiency FELs

    SciTech Connect

    Sessler, A.M.

    1989-04-01

    High power, high efficiency FELs require tapering, as the particles loose energy, so as to maintain resonance between the electromagnetic wave and the particles. They also require focusing of the particles (usually done with curved pole faces) and focusing of the electromagnetic wave (i.e. optical guiding). In addition, one must avoid transverse beam instabilities (primarily resistive wall) and longitudinal instabilities (i.e sidebands). 18 refs., 7 figs., 3 tabs.

  13. High temperature, high power piezoelectric composite transducers.

    PubMed

    Lee, Hyeong Jae; Zhang, Shujun; Bar-Cohen, Yoseph; Sherrit, Stewart

    2014-08-08

    Piezoelectric composites are a class of functional materials consisting of piezoelectric active materials and non-piezoelectric passive polymers, mechanically attached together to form different connectivities. These composites have several advantages compared to conventional piezoelectric ceramics and polymers, including improved electromechanical properties, mechanical flexibility and the ability to tailor properties by using several different connectivity patterns. These advantages have led to the improvement of overall transducer performance, such as transducer sensitivity and bandwidth, resulting in rapid implementation of piezoelectric composites in medical imaging ultrasounds and other acoustic transducers. Recently, new piezoelectric composite transducers have been developed with optimized composite components that have improved thermal stability and mechanical quality factors, making them promising candidates for high temperature, high power transducer applications, such as therapeutic ultrasound, high power ultrasonic wirebonding, high temperature non-destructive testing, and downhole energy harvesting. This paper will present recent developments of piezoelectric composite technology for high temperature and high power applications. The concerns and limitations of using piezoelectric composites will also be discussed, and the expected future research directions will be outlined.

  14. High Temperature, High Power Piezoelectric Composite Transducers

    PubMed Central

    Lee, Hyeong Jae; Zhang, Shujun; Bar-Cohen, Yoseph; Sherrit, StewarT.

    2014-01-01

    Piezoelectric composites are a class of functional materials consisting of piezoelectric active materials and non-piezoelectric passive polymers, mechanically attached together to form different connectivities. These composites have several advantages compared to conventional piezoelectric ceramics and polymers, including improved electromechanical properties, mechanical flexibility and the ability to tailor properties by using several different connectivity patterns. These advantages have led to the improvement of overall transducer performance, such as transducer sensitivity and bandwidth, resulting in rapid implementation of piezoelectric composites in medical imaging ultrasounds and other acoustic transducers. Recently, new piezoelectric composite transducers have been developed with optimized composite components that have improved thermal stability and mechanical quality factors, making them promising candidates for high temperature, high power transducer applications, such as therapeutic ultrasound, high power ultrasonic wirebonding, high temperature non-destructive testing, and downhole energy harvesting. This paper will present recent developments of piezoelectric composite technology for high temperature and high power applications. The concerns and limitations of using piezoelectric composites will also be discussed, and the expected future research directions will be outlined. PMID:25111242

  15. High assurance SPIRAL

    NASA Astrophysics Data System (ADS)

    Franchetti, Franz; Sandryhaila, Aliaksei; Johnson, Jeremy R.

    2014-06-01

    In this paper we introduce High Assurance SPIRAL to solve the last mile problem for the synthesis of high assurance implementations of controllers for vehicular systems that are executed in today's and future embedded and high performance embedded system processors. High Assurance SPIRAL is a scalable methodology to translate a high level specification of a high assurance controller into a highly resource-efficient, platform-adapted, verified control software implementation for a given platform in a language like C or C++. High Assurance SPIRAL proves that the implementation is equivalent to the specification written in the control engineer's domain language. Our approach scales to problems involving floating-point calculations and provides highly optimized synthesized code. It is possible to estimate the available headroom to enable assurance/performance trade-offs under real-time constraints, and enables the synthesis of multiple implementation variants to make attacks harder. At the core of High Assurance SPIRAL is the Hybrid Control Operator Language (HCOL) that leverages advanced mathematical constructs expressing the controller specification to provide high quality translation capabilities. Combined with a verified/certified compiler, High Assurance SPIRAL provides a comprehensive complete solution to the efficient synthesis of verifiable high assurance controllers. We demonstrate High Assurance SPIRALs capability by co-synthesizing proofs and implementations for attack detection and sensor spoofing algorithms and deploy the code as ROS nodes on the Landshark unmanned ground vehicle and on a Synthetic Car in a real-time simulator.

  16. Causes of High Cholesterol

    MedlinePlus

    ... Venous Thromboembolism Aortic Aneurysm More Causes of High Cholesterol Updated:Jul 5,2017 If you have high ... and procedures related to heart disease and stroke. Cholesterol • Home • About Cholesterol • HDL, LDL, and Triglycerides • Causes ...

  17. High blood pressure - infants

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/007329.htm High blood pressure - infants To use the sharing features on this page, please enable JavaScript. High blood pressure (hypertension) is an increase in the force of ...

  18. High Blood Pressure Prevention

    MedlinePlus

    ... version of this page please turn Javascript on. High Blood Pressure Prevention Steps You Can Take You can take steps to prevent high blood pressure by adopting these healthy lifestyle habits. Follow a ...

  19. High blood pressure

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/000468.htm High blood pressure To use the sharing features on this page, ... body. Hypertension is the term used to describe high blood pressure. Blood pressure readings are given as two numbers. ...

  20. Hypertension (High Blood Pressure)

    MedlinePlus

    ... Visitor Information RePORT NIH Fact Sheets Home > Hypertension (High Blood Pressure) Small Text Medium Text Large Text Hypertension (High Blood Pressure) YESTERDAY Hypertension is a silent killer because it ...

  1. High power microwave generator

    DOEpatents

    Ekdahl, Carl A.

    1986-01-01

    A microwave generator efficiently converts the energy of an intense relativistic electron beam (REB) into a high-power microwave emission using the Smith-Purcell effect which is related to Cerenkov radiation. Feedback for efficient beam bunching and high gain is obtained by placing a cylindrical Smith-Purcell transmission grating on the axis of a toroidal resonator. High efficiency results from the use of a thin cold annular highly-magnetized REB that is closely coupled to the resonant structure.

  2. High power microwave generator

    DOEpatents

    Ekdahl, C.A.

    1983-12-29

    A microwave generator efficiently converts the energy of an intense relativistic electron beam (REB) into a high-power microwave emission using the Smith-Purcell effect which is related to Cerenkov radiation. Feedback for efficient beam bunching and high gain is obtained by placing a cylindrical Smith-Purcell transmission grating on the axis of a toroidal resonator. High efficiency results from the use of a thin cold annular highly-magnetized REB that is closely coupled to the resonant structure.

  3. High energy neutron radiography

    SciTech Connect

    Gavron, A.; Morley, K.; Morris, C.; Seestrom, S.; Ullmann, J.; Yates, G.; Zumbro, J.

    1996-06-01

    High-energy spallation neutron sources are now being considered in the US and elsewhere as a replacement for neutron beams produced by reactors. High-energy and high intensity neutron beams, produced by unmoderated spallation sources, open potential new vistas of neutron radiography. The authors discuss the basic advantages and disadvantages of high-energy neutron radiography, and consider some experimental results obtained at the Weapons Neutron Research (WNR) facility at Los Alamos.

  4. High Tech High: Cruising on the Internet.

    ERIC Educational Resources Information Center

    Wilson, Thomas F.

    1995-01-01

    A "driver's license" at one suburban Minnesota high school is a free round-trip ticket to the world. The Internet allows students to stroll through the Louvre, tour the White House, or examine current satellite weather photos at NASA's computer center. Students are developing friendships, exploring different cultures, and learning…

  5. High power, high beam quality regenerative amplifier

    DOEpatents

    Hackel, L.A.; Dane, C.B.

    1993-08-24

    A regenerative laser amplifier system generates high peak power and high energy per pulse output beams enabling generation of X-rays used in X-ray lithography for manufacturing integrated circuits. The laser amplifier includes a ring shaped optical path with a limited number of components including a polarizer, a passive 90 degree phase rotator, a plurality of mirrors, a relay telescope, and a gain medium, the components being placed close to the image plane of the relay telescope to reduce diffraction or phase perturbations in order to limit high peak intensity spiking. In the ring, the beam makes two passes through the gain medium for each transit of the optical path to increase the amplifier gain to loss ratio. A beam input into the ring makes two passes around the ring, is diverted into an SBS phase conjugator and proceeds out of the SBS phase conjugator back through the ring in an equal but opposite direction for two passes, further reducing phase perturbations. A master oscillator inputs the beam through an isolation cell (Faraday or Pockels) which transmits the beam into the ring without polarization rotation. The isolation cell rotates polarization only in beams proceeding out of the ring to direct the beams out of the amplifier. The diffraction limited quality of the input beam is preserved in the amplifier so that a high power output beam having nearly the same diffraction limited quality is produced.

  6. High power, high beam quality regenerative amplifier

    DOEpatents

    Hackel, Lloyd A.; Dane, Clifford B.

    1993-01-01

    A regenerative laser amplifier system generates high peak power and high energy per pulse output beams enabling generation of X-rays used in X-ray lithography for manufacturing integrated circuits. The laser amplifier includes a ring shaped optical path with a limited number of components including a polarizer, a passive 90 degree phase rotator, a plurality of mirrors, a relay telescope, and a gain medium, the components being placed close to the image plane of the relay telescope to reduce diffraction or phase perturbations in order to limit high peak intensity spiking. In the ring, the beam makes two passes through the gain medium for each transit of the optical path to increase the amplifier gain to loss ratio. A beam input into the ring makes two passes around the ring, is diverted into an SBS phase conjugator and proceeds out of the SBS phase conjugator back through the ring in an equal but opposite direction for two passes, further reducing phase perturbations. A master oscillator inputs the beam through an isolation cell (Faraday or Pockels) which transmits the beam into the ring without polarization rotation. The isolation cell rotates polarization only in beams proceeding out of the ring to direct the beams out of the amplifier. The diffraction limited quality of the input beam is preserved in the amplifier so that a high power output beam having nearly the same diffraction limited quality is produced.

  7. High power, high reliability laser diodes

    NASA Astrophysics Data System (ADS)

    Scifres, D. R.; Welch, D. F.; Craig, R. R.; Zucker, E.; Major, J. S.; Harnagel, G. L.; Sakamoto, M.; Haden, J. M.; Endriz, J. G.; Kung, H.

    1992-06-01

    Results are presented on catastrophic damage limits and life-test measurements for four types of high-power laser diodes operating at wavelengths between 980 nm and 690 nm. The laser diodes under consideration are CW multimode lasers, CW laser bars, quasi-CW bars/2D stacked arrays, and single transverse mode lasers.

  8. High Tech High: Cruising on the Internet.

    ERIC Educational Resources Information Center

    Wilson, Thomas F.

    1995-01-01

    A "driver's license" at one suburban Minnesota high school is a free round-trip ticket to the world. The Internet allows students to stroll through the Louvre, tour the White House, or examine current satellite weather photos at NASA's computer center. Students are developing friendships, exploring different cultures, and learning…

  9. High Resolution Science with High Redshift Galaxies

    NASA Astrophysics Data System (ADS)

    Windhorst, R.

    I will first review high resolution science that has been done with the Hubble Space Telescope on high redshift galaxies Next I will review the capabilities of the 6 5 meter James Webb Space Telescope JWST which is an optimized infrared telescope that can deploy automatically in space slated for launch to a halo L2 orbit in 2013 I will outline how the JWST can go about measuring First Light Reionization and Galaxy Assembly building on lessons learned from the Hubble Space Telescope I will show what more nearby galaxies observed in their restframe UV--optical light may look like to JWST at high redshifts Last I will summarize the Generation-X mission concept for an X-ray telescope designed to study the very early universe with 1000-times greater sensitivity than current facilities Gen-X will study the first generations of stars and black holes in the epoch z 10-20 the evolution of black holes and galaxies from high z to the present the chemical evolution of the universe and the properties of matter under extreme conditions This requires an effective area of 100 m 2 at 1 keV an angular resolution of 0 1 HPD over 0 1-10 keV

  10. High performance systems

    SciTech Connect

    Vigil, M.B.

    1995-03-01

    This document provides a written compilation of the presentations and viewgraphs from the 1994 Conference on High Speed Computing given at the High Speed Computing Conference, {open_quotes}High Performance Systems,{close_quotes} held at Gleneden Beach, Oregon, on April 18 through 21, 1994.

  11. Evaluating High School IT

    ERIC Educational Resources Information Center

    Thompson, Brett A.

    2004-01-01

    Since its inception in 1997, Cisco's curriculum has entered thousands of high schools across the U.S. and around the world for two reasons: (1) Cisco has a large portion of the computer networking market, and thus has the resources for and interest in developing high school academies; and (2) high school curriculum development teams recognize the…

  12. Early College High Schools

    ERIC Educational Resources Information Center

    Dessoff, Alan

    2011-01-01

    For at-risk students who stand little chance of going to college, or even finishing high school, a growing number of districts have found a solution: Give them an early start in college while they still are in high school. The early college high school (ECHS) movement that began with funding from the Bill and Melinda Gates Foundation 10 years ago…

  13. Evaluating High School IT

    ERIC Educational Resources Information Center

    Thompson, Brett A.

    2004-01-01

    Since its inception in 1997, Cisco's curriculum has entered thousands of high schools across the U.S. and around the world for two reasons: (1) Cisco has a large portion of the computer networking market, and thus has the resources for and interest in developing high school academies; and (2) high school curriculum development teams recognize the…

  14. Early College High Schools

    ERIC Educational Resources Information Center

    Dessoff, Alan

    2011-01-01

    For at-risk students who stand little chance of going to college, or even finishing high school, a growing number of districts have found a solution: Give them an early start in college while they still are in high school. The early college high school (ECHS) movement that began with funding from the Bill and Melinda Gates Foundation 10 years ago…

  15. High Technology Needs Assessment.

    ERIC Educational Resources Information Center

    Southeastern Louisiana Univ., Hammond.

    A project produced a high technology status report providing needs assessment data for educational planning. The purpose was to determine the impact and future of high technology in Louisiana. Information was obtained from 68 Louisiana manufacturing industries by mailed questionnaire. Data indicated that 45 industries were involved in high tech. A…

  16. High lift aerodynamics

    NASA Technical Reports Server (NTRS)

    Sullivan, John; Schneider, Steve; Campbell, Bryan; Bucci, Greg; Boone, Rod; Torgerson, Shad; Erausquin, Rick; Knauer, Chad

    1994-01-01

    The current program is aimed at providing a physical picture of the flow physics and quantitative turbulence data of the interaction of a high Reynolds number wake with a flap element. The impact of high lift on aircraft performance is studied for a 150 passenger transport aircraft with the goal of designing optimum high lift systems with minimum complexity.

  17. High performance polymer development

    NASA Technical Reports Server (NTRS)

    Hergenrother, Paul M.

    1991-01-01

    The term high performance as applied to polymers is generally associated with polymers that operate at high temperatures. High performance is used to describe polymers that perform at temperatures of 177 C or higher. In addition to temperature, other factors obviously influence the performance of polymers such as thermal cycling, stress level, and environmental effects. Some recent developments at NASA Langley in polyimides, poly(arylene ethers), and acetylenic terminated materials are discussed. The high performance/high temperature polymers discussed are representative of the type of work underway at NASA Langley Research Center. Further improvement in these materials as well as the development of new polymers will provide technology to help meet NASA future needs in high performance/high temperature applications. In addition, because of the combination of properties offered by many of these polymers, they should find use in many other applications.

  18. High temperature reactors

    NASA Astrophysics Data System (ADS)

    Dulera, I. V.; Sinha, R. K.

    2008-12-01

    With the advent of high temperature reactors, nuclear energy, in addition to producing electricity, has shown enormous potential for the production of alternate transport energy carrier such as hydrogen. High efficiency hydrogen production processes need process heat at temperatures around 1173-1223 K. Bhabha Atomic Research Centre (BARC), is currently developing concepts of high temperature reactors capable of supplying process heat around 1273 K. These reactors would provide energy to facilitate combined production of hydrogen, electricity, and drinking water. Compact high temperature reactor is being developed as a technology demonstrator for associated technologies. Design has been also initiated for a 600 MWth innovative high temperature reactor. High temperature reactor development programme has opened new avenues for research in areas like advanced nuclear fuels, high temperature and corrosion resistant materials and protective coatings, heavy liquid metal coolant technologies, etc. The paper highlights design of these reactors and their material related requirements.

  19. High Resolution, High Frame Rate Video Technology

    NASA Technical Reports Server (NTRS)

    1990-01-01

    Papers and working group summaries presented at the High Resolution, High Frame Rate Video (HHV) Workshop are compiled. HHV system is intended for future use on the Space Shuttle and Space Station Freedom. The Workshop was held for the dual purpose of: (1) allowing potential scientific users to assess the utility of the proposed system for monitoring microgravity science experiments; and (2) letting technical experts from industry recommend improvements to the proposed near-term HHV system. The following topics are covered: (1) State of the art in the video system performance; (2) Development plan for the HHV system; (3) Advanced technology for image gathering, coding, and processing; (4) Data compression applied to HHV; (5) Data transmission networks; and (6) Results of the users' requirements survey conducted by NASA.

  20. High pressure and high temperature apparatus

    DOEpatents

    Voronov, Oleg A.

    2005-09-13

    A design for high pressure/high temperature apparatus and reaction cell to achieve .about.30 GPa pressure in .about.1 cm volume and .about.100 GPa pressure in .about.1 mm volumes and 20-5000.degree. C. temperatures in a static regime. The device includes profiled anvils (28) action on a reaction cell (14, 16) containing the material (26) to be processed. The reaction cell includes a heater (18) surrounded by insulating layers and screens. Surrounding the anvils are cylindrical inserts and supporting rings (30-48) whose hardness increases towards the reaction cell. These volumes may be increased considerably if applications require it, making use of presses that have larger loading force capability, larger frames and using larger anvils.

  1. A simple, high efficiency, high resolution spectropolarimeter

    NASA Astrophysics Data System (ADS)

    Barden, Samuel C.

    2012-09-01

    A simple concept is described that uses volume phase holographic gratings as polarizing dispersers for a high efficiency, high resolution spectropolarimeter. Although the idea has previously been mentioned in the literature as possible, such a concept has not been explored in detail. Performance analysis is presented for a VPHG spectropolarimeter concept that could be utilized for both solar and night-time astronomy. Instrumental peak efficiency can approach 100% with spectral dispersions permitting R~200,000 spectral resolution with diffraction limited telescopes. The instrument has 3-channels: two dispersed image planes with orthogonal polarization and an undispersed image plane. The concept has a range of versatility where it could be configured (with appropriate half-wave plates) for slit-fed spectroscopy or without slits for snapshot/hyperspectral/tomographic spectroscopic imaging. Multiplex gratings could also be used for the simultaneous recording of two separate spectral bands or multiple instruments could be daisy chained with beam splitters for further spectral coverage.

  2. High modulus high temperature glass fibers

    NASA Technical Reports Server (NTRS)

    Bacon, J. F.

    1973-01-01

    The search for a new high-modulus, high-temperature glass fiber involved the preparation of 500 glass compositions lying in 12 glass fields. These systems consisted primarily of low atomic number oxides and rare-earth oxides. Direct optical measurements of the kinetics of crystallization of the cordierite-rare earth system, for example, showed that the addition of rare-earth oxides decreased the rate of formation of cordierite crystals. Glass samples prepared from these systems proved that the rare-earth oxides made large specific contributions to the Young's modulus of the glasses. The best glasses have moduli greater than 21 million psi, the best glass fibers have moduli greater than 18 million psi, and the best glass fiber-epoxy resin composites have tensile strengths of 298,000 psi, compressive strengths of at least 220,000 psi, flexural strengths of 290,000 psi, and short-beam shear strengths of almost 17,000 psi.

  3. HIGH VOLTAGE, HIGH CURRENT SPARK GAP SWITCH

    DOEpatents

    Dike, R.S.; Lier, D.W.; Schofield, A.E.; Tuck, J.L.

    1962-04-17

    A high voltage and current spark gap switch comprising two main electrodes insulatingly supported in opposed spaced relationship and a middle electrode supported medially between the main electrodes and symmetrically about the median line of the main electrodes is described. The middle electrode has a perforation aligned with the median line and an irradiation electrode insulatingly supported in the body of the middle electrode normal to the median line and protruding into the perforation. (AEC)

  4. High frequency, high power capacitor development

    NASA Technical Reports Server (NTRS)

    White, C. W.; Hoffman, P. S.

    1983-01-01

    A program to develop a special high energy density, high power transfer capacitor to operate at frequency of 40 kHz, 600 V rms at 125 A rms plus 600 V dc bias for space operation. The program included material evaluation and selection, a capacitor design was prepared, a thermal analysis performed on the design. Fifty capacitors were manufactured for testing at 10 kHz and 40 kHz for 50 hours at Industrial Electric Heating Co. of Columbus, Ohio. The vacuum endurance test used on environmental chamber and temperature plate furnished by Maxwell. The capacitors were energized with a special power conditioning apparatus developed by Industrial Electric Heating Co. Temperature conditions of the capacitors were monitored by IEHCo test equipment. Successful completion of the vacuum endurance test series confirmed achievement of the main goal of producing a capacitor or reliable operation at high frequency in an environment normally not hospitable to electrical and electronic components. The capacitor developed compared to a typical commercial capacitor at the 40 kHz level represents a decrease in size and weight by a factor of seven.

  5. High frequency, high power capacitor development

    NASA Astrophysics Data System (ADS)

    White, C. W.; Hoffman, P. S.

    1983-03-01

    A program to develop a special high energy density, high power transfer capacitor to operate at frequency of 40 kHz, 600 V rms at 125 A rms plus 600 V dc bias for space operation. The program included material evaluation and selection, a capacitor design was prepared, a thermal analysis performed on the design. Fifty capacitors were manufactured for testing at 10 kHz and 40 kHz for 50 hours at Industrial Electric Heating Co. of Columbus, Ohio. The vacuum endurance test used on environmental chamber and temperature plate furnished by Maxwell. The capacitors were energized with a special power conditioning apparatus developed by Industrial Electric Heating Co. Temperature conditions of the capacitors were monitored by IEHCo test equipment. Successful completion of the vacuum endurance test series confirmed achievement of the main goal of producing a capacitor or reliable operation at high frequency in an environment normally not hospitable to electrical and electronic components. The capacitor developed compared to a typical commercial capacitor at the 40 kHz level represents a decrease in size and weight by a factor of seven.

  6. High output lamp with high brightness

    DOEpatents

    Kirkpatrick, Douglas A.; Bass, Gary K.; Copsey, Jesse F.; Garber, Jr., William E.; Kwong, Vincent H.; Levin, Izrail; MacLennan, Donald A.; Roy, Robert J.; Steiner, Paul E.; Tsai, Peter; Turner, Brian P.

    2002-01-01

    An ultra bright, low wattage inductively coupled electrodeless aperture lamp is powered by a solid state RF source in the range of several tens to several hundreds of watts at various frequencies in the range of 400 to 900 MHz. Numerous novel lamp circuits and components are disclosed including a wedding ring shaped coil having one axial and one radial lead, a high accuracy capacitor stack, a high thermal conductivity aperture cup and various other aperture bulb configurations, a coaxial capacitor arrangement, and an integrated coil and capacitor assembly. Numerous novel RF circuits are also disclosed including a high power oscillator circuit with reduced complexity resonant pole configuration, parallel RF power FET transistors with soft gate switching, a continuously variable frequency tuning circuit, a six port directional coupler, an impedance switching RF source, and an RF source with controlled frequency-load characteristics. Numerous novel RF control methods are disclosed including controlled adjustment of the operating frequency to find a resonant frequency and reduce reflected RF power, controlled switching of an impedance switched lamp system, active power control and active gate bias control.

  7. Highly directional thermal emitter

    DOEpatents

    Ribaudo, Troy; Shaner, Eric A; Davids, Paul; Peters, David W

    2015-03-24

    A highly directional thermal emitter device comprises a two-dimensional periodic array of heavily doped semiconductor structures on a surface of a substrate. The array provides a highly directional thermal emission at a peak wavelength between 3 and 15 microns when the array is heated. For example, highly doped silicon (HDSi) with a plasma frequency in the mid-wave infrared was used to fabricate nearly perfect absorbing two-dimensional gratings structures that function as highly directional thermal radiators. The absorption and emission characteristics of the HDSi devices possessed a high degree of angular dependence for infrared absorption in the 10-12 micron range, while maintaining high reflectivity of solar radiation (.about.64%) at large incidence angles.

  8. High speed handpieces

    PubMed Central

    Bhandary, Nayan; Desai, Asavari; Shetty, Y Bharath

    2014-01-01

    High speed instruments are versatile instruments used by clinicians of all specialties of dentistry. It is important for clinicians to understand the types of high speed handpieces available and the mechanism of working. The centers for disease control and prevention have issued guidelines time and again for disinfection and sterilization of high speed handpieces. This article presents the recent developments in the design of the high speed handpieces. With a view to prevent hospital associated infections significant importance has been given to disinfection, sterilization & maintenance of high speed handpieces. How to cite the article: Bhandary N, Desai A, Shetty YB. High speed handpieces. J Int Oral Health 2014;6(1):130-2. PMID:24653618

  9. High lift selected concepts

    NASA Technical Reports Server (NTRS)

    Henderson, M. L.

    1979-01-01

    The benefits to high lift system maximum life and, alternatively, to high lift system complexity, of applying analytic design and analysis techniques to the design of high lift sections for flight conditions were determined and two high lift sections were designed to flight conditions. The influence of the high lift section on the sizing and economics of a specific energy efficient transport (EET) was clarified using a computerized sizing technique and an existing advanced airplane design data base. The impact of the best design resulting from the design applications studies on EET sizing and economics were evaluated. Flap technology trade studies, climb and descent studies, and augmented stability studies are included along with a description of the baseline high lift system geometry, a calculation of lift and pitching moment when separation is present, and an inverse boundary layer technique for pressure distribution synthesis and optimization.

  10. High voltage coaxial switch

    DOEpatents

    Rink, John P.

    1983-07-19

    A coaxial high voltage, high current switch having a solid cylindrical cold cathode coaxially surrounded by a thin hollow cylindrical inner electrode and a larger hollow cylindrical outer electrode. A high voltage trigger between the cathode and the inner electrode causes electrons to be emitted from the cathode and flow to the inner electrode preferably through a vacuum. Some of the electrons penetrate the inner electrode and cause a volumetric discharge in the gas (which may be merely air) between the inner and outer electrodes. The discharge provides a low impedance path between a high voltage charge placed on the outer electrode and a load (which may be a high power laser) coupled to the inner electrode. For high repetition rate the gas between the inner and outer electrodes may be continuously exchanged or refreshed under pressure.

  11. High voltage coaxial switch

    DOEpatents

    Rink, J.P.

    1983-07-19

    A coaxial high voltage, high current switch having a solid cylindrical cold cathode coaxially surrounded by a thin hollow cylindrical inner electrode and a larger hollow cylindrical outer electrode. A high voltage trigger between the cathode and the inner electrode causes electrons to be emitted from the cathode and flow to the inner electrode preferably through a vacuum. Some of the electrons penetrate the inner electrode and cause a volumetric discharge in the gas (which may be merely air) between the inner and outer electrodes. The discharge provides a low impedance path between a high voltage charge placed on the outer electrode and a load (which may be a high power laser) coupled to the inner electrode. For high repetition rate the gas between the inner and outer electrodes may be continuously exchanged or refreshed under pressure. 3 figs.

  12. High Redshift GRBs

    NASA Technical Reports Server (NTRS)

    Gehrels, Neil; Cannizzo, John K.

    2012-01-01

    The Swift mission has opened a new, high redshift window on the universe. In this review we provide an overview of gamma-ray burst (GRB) science, describe the Swift mission, discuss high-z GRBs and tools for high-z studies, and look forward at future capabilities. A new mission concept - Lobster - is described that would monitor the X-ray sky at order of magnitude higher sensitivity than current missions.

  13. Galaxies at High Redshift

    NASA Astrophysics Data System (ADS)

    Pérez-Fournon, I.; Balcells, M.; Moreno-Insertis, F.; Sánchez, F.

    2010-08-01

    Participants; Group photograph; Preface; Acknowledgements; 1. Galaxy formation and evolution: recent progress R. Ellis; 2. Galaxies at high redshift M. Dickinson; 3. High-redshift galaxies: the far-infrared and sub-millimeter view A. Franceschini; 4. Quasar absorption lines J. Bechtold; 5. Stellar population synthesis models at low and high redshift G. Bruzual A.; 6. Elliptical galaxies K. C. Freeman; 7. Disk galaxies K. C. Freeman; 8. Dark matter in disk galaxies K. C. Freeman.

  14. High Temperature Semiconductor Process

    NASA Technical Reports Server (NTRS)

    1998-01-01

    A sputtering deposition system capable of depositing large areas of high temperature superconducting materials was developed by CVC Products, Inc. with the support of the Jet Propulsion Laboratory SBIR (Small Business Innovative Research) program. The system was devleoped for NASA to produce high quality films of high temperature superconducting material for microwave communication system components. The system is also being used to deposit ferroelectric material for capacitors and the development of new electro-optical materials.2002103899

  15. Aspirated High Pressure Compressor

    DTIC Science & Technology

    2006-08-01

    Std. Z39.18 A proved for Public Release Distribution Unlimited ABSTRACT (continued from Blockl4) within 0.5 percentage points . High response static...attention was given to the design of the instrumentation to obtain efficiency measurements within 0.5 percentage points . High response static pressure...prior empirical knowledge [3]. 0.5 percentage points . High response static pressure The new proposition addressed here is that aspiration offers

  16. HIGH ENERGY RATE EXTRUSION.

    DTIC Science & Technology

    Thin structural shapes can now be produced by high velocity extrusion equipment. Tooling, dies, die coatings, lubricants and general processing...degrees was important in reducing the initial peak stresses to a controllable level and tooling failures were reduced by using high strength (Rc 55-60...the high inertial forces present) can be lessened and eliminated in many cases by the selection of low reduction ratios (15:1 or below) and low impact speeds. (Author)

  17. High temperature refrigerator

    DOEpatents

    Steyert, Jr., William A.

    1978-01-01

    A high temperature magnetic refrigerator which uses a Stirling-like cycle in which rotating magnetic working material is heated in zero field and adiabatically magnetized, cooled in high field, then adiabatically demagnetized. During this cycle said working material is in heat exchange with a pumped fluid which absorbs heat from a low temperature heat source and deposits heat in a high temperature reservoir. The magnetic refrigeration cycle operates at an efficiency 70% of Carnot.

  18. High temperature furnace

    DOEpatents

    Borkowski, Casimer J.

    1976-08-03

    A high temperature furnace for use above 2000.degree.C is provided that features fast initial heating and low power consumption at the operating temperature. The cathode is initially heated by joule heating followed by electron emission heating at the operating temperature. The cathode is designed for routine large temperature excursions without being subjected to high thermal stresses. A further characteristic of the device is the elimination of any ceramic components from the high temperature zone of the furnace.

  19. High altitude decelerator systems

    NASA Technical Reports Server (NTRS)

    Silbert, Mendel N.; Moltedo, A. David; Gilbertson, Gaylord S.

    1989-01-01

    High Altitude Decelerator Systems are used to provide a stable descending platform when deployed from a sounding rocket at altitudes greater than 40 kilometers allowing a scientific mission to be conducted in a specific altitude region. The High Altitude Decelerator is designed to provide a highly stable, high drag area system packed in a minimum volume to deploy successfully from a sounding rocket. Deployment altitudes greater than 100 kilometers have been successfully demonstrated at dynamic pressures as low as 0.004 pounds per square foot.

  20. Highly fluorinated polymers

    NASA Technical Reports Server (NTRS)

    1994-01-01

    Work in the following areas is discussed: fluorinated poly(ether-ketone)s containing phosphorus; polyacrylates containing highly polar fluorinated pendant groups; and polyalkylene- and arylene-difluoroterephthalates.

  1. High Reynolds Number Research

    NASA Technical Reports Server (NTRS)

    Baals, D. D. (Editor)

    1977-01-01

    Fundamental aerodynamic questions for which high Reynolds number experimental capability is required are discussed. The operational characteristics and design features of the National Transonic Facility are reviewed.

  2. High-temperature thermodynamics.

    NASA Technical Reports Server (NTRS)

    Margrave, J. L.

    1967-01-01

    High temperature thermodynamics requiring species and phases identification, crystal structures, molecular geometries and vibrational, rotational and electronic energy levels and equilibrium constants

  3. Athletes at High Altitude

    PubMed Central

    Khodaee, Morteza; Grothe, Heather L.; Seyfert, Jonathan H.; VanBaak, Karin

    2016-01-01

    Context: Athletes at different skill levels perform strenuous physical activity at high altitude for a variety of reasons. Multiple team and endurance events are held at high altitude and may place athletes at increased risk for developing acute high altitude illness (AHAI). Training at high altitude has been a routine part of preparation for some of the high level athletes for a long time. There is a general belief that altitude training improves athletic performance for competitive and recreational athletes. Evidence Acquisition: A review of relevant publications between 1980 and 2015 was completed using PubMed and Google Scholar. Study Design: Clinical review. Level of Evidence: Level 3. Results: AHAI is a relatively uncommon and potentially serious condition among travelers to altitudes above 2500 m. The broad term AHAI includes several syndromes such as acute mountain sickness (AMS), high altitude pulmonary edema (HAPE), and high altitude cerebral edema (HACE). Athletes may be at higher risk for developing AHAI due to faster ascent and more vigorous exertion compared with nonathletes. Evidence regarding the effects of altitude training on athletic performance is weak. The natural live high, train low altitude training strategy may provide the best protocol for enhancing endurance performance in elite and subelite athletes. High altitude sports are generally safe for recreational athletes, but they should be aware of their individual risks. Conclusion: Individualized and appropriate acclimatization is an essential component of injury and illness prevention. PMID:26863894

  4. High-Altitude Medicine.

    PubMed

    Johnson, Nicholas J; Luks, Andrew M

    2016-03-01

    Individuals may seek the advice of medical providers when considering travel to high altitude. This article provides a basic framework for counseling and evaluating such patients. After defining "high altitude" and describing the key environmental features at higher elevations, the physiologic changes that occur at high altitude and how these changes are experienced by the traveler are discussed. Clinical features and strategies for prevention and treatment of the main forms of acute altitude illness are outlined, and frameworks for approaching the common clinical scenarios that may be encountered regarding high-altitude travelers are provided. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. High power, high frequency, vacuum flange

    DOEpatents

    Felker, Brian; McDaniel, Michael R.

    1993-01-01

    An improved waveguide flange is disclosed for high power operation that helps prevent arcs from being initiated at the junctions between waveguide sections. The flanges at the end of the waveguide sections have counterbores surrounding the waveguide tubes. When the sections are bolted together the counterbores form a groove that holds a fully annealed copper gasket. Each counterbore has a beveled step that is specially configured to insure the gasket forms a metal-to-metal vacuum seal without gaps or sharp edges. The resultant inner surface of the waveguide is smooth across the junctions between waveguide sections, and arcing is prevented.

  6. High performance, high density hydrocarbon fuels

    NASA Technical Reports Server (NTRS)

    Frankenfeld, J. W.; Hastings, T. W.; Lieberman, M.; Taylor, W. F.

    1978-01-01

    The fuels were selected from 77 original candidates on the basis of estimated merit index and cost effectiveness. The ten candidates consisted of 3 pure compounds, 4 chemical plant streams and 3 refinery streams. Critical physical and chemical properties of the candidate fuels were measured including heat of combustion, density, and viscosity as a function of temperature, freezing points, vapor pressure, boiling point, thermal stability. The best all around candidate was found to be a chemical plant olefin stream rich in dicyclopentadiene. This material has a high merit index and is available at low cost. Possible problem areas were identified as low temperature flow properties and thermal stability. An economic analysis was carried out to determine the production costs of top candidates. The chemical plant and refinery streams were all less than 44 cent/kg while the pure compounds were greater than 44 cent/kg. A literature survey was conducted on the state of the art of advanced hydrocarbon fuel technology as applied to high energy propellents. Several areas for additional research were identified.

  7. Highly Parallel, High-Precision Numerical Integration

    SciTech Connect

    Bailey, David H.; Borwein, Jonathan M.

    2005-04-22

    This paper describes a scheme for rapidly computing numerical values of definite integrals to very high accuracy, ranging from ordinary machine precision to hundreds or thousands of digits, even for functions with singularities or infinite derivatives at endpoints. Such a scheme is of interest not only in computational physics and computational chemistry, but also in experimental mathematics, where high-precision numerical values of definite integrals can be used to numerically discover new identities. This paper discusses techniques for a parallel implementation of this scheme, then presents performance results for 1-D and 2-D test suites. Results are also given for a certain problem from mathematical physics, which features a difficult singularity, confirming a conjecture to 20,000 digit accuracy. The performance rate for this latter calculation on 1024 CPUs is 690 Gflop/s. We believe that this and one other 20,000-digit integral evaluation that we report are the highest-precision non-trivial numerical integrations performed to date.

  8. High Involvement Work Teams.

    ERIC Educational Resources Information Center

    1996

    These three papers were presented at a symposium on high-involvement work teams moderated by Michael Leimbach at the 1996 conference of the Academy of Human Resource Development. "Beyond Training to the New Learning Environment: Workers on the High-Involvement Frontline" (Joseph Anthony Ilacqua, Carol Ann Zulauf) shows the link between…

  9. High School Gifted.

    ERIC Educational Resources Information Center

    Drum, Jean, Ed.

    1993-01-01

    This theme issue on gifted high school students presents several feature articles, a California legislative update, and an editorial. In "Summer Seminar '93--California in the 21st Century," Janis Van Dreal describes a 2-week residential program in which gifted high school students examined California's future. "Visiting a Gifted…

  10. High Involvement Work Teams.

    ERIC Educational Resources Information Center

    1996

    These three papers were presented at a symposium on high-involvement work teams moderated by Michael Leimbach at the 1996 conference of the Academy of Human Resource Development. "Beyond Training to the New Learning Environment: Workers on the High-Involvement Frontline" (Joseph Anthony Ilacqua, Carol Ann Zulauf) shows the link between…

  11. High energy forming facility

    NASA Technical Reports Server (NTRS)

    Ciurlionis, B.

    1967-01-01

    Watertight, high-explosive forming facility, 25 feet in diameter and 15 feet deep, withstands repeated explosions of 10 pounds of TNT equivalent. The shell is fabricated of high strength steel and allows various structural elements to deform or move elastically and independently while retaining structural integrity.

  12. High-Conflict Divorce.

    ERIC Educational Resources Information Center

    Johnston, Janet R.

    1994-01-01

    Reviews available research studies of high-conflict divorce and its effects on children. Factors believed to contribute to high-conflict divorce are explored, and a model of their interrelationships is proposed. Dispute resolution, intervention, and prevention programs are discussed, and implications for social policy are outlined. (SLD)

  13. High density photovoltaic

    SciTech Connect

    Haigh, R.E.; Jacobson, G.F.; Wojtczuk, S.

    1997-10-14

    Photovoltaic technology can directly generate high voltages in a solid state material through the series interconnect of many photovoltaic diodes. We are investigating the feasibility of developing an electrically isolated, high-voltage power supply using miniature photovoltaic devices that convert optical energy to electrical energy.

  14. High and Dry

    ERIC Educational Resources Information Center

    Johnson, Robert L.

    2005-01-01

    High-performance schools are facilities that improve the learning environment while saving energy, resources and money. Creating a high-performance school requires an integrated design approach. Key systems--including lighting, HVAC, electrical and plumbing--must be considered from the beginning of the design process. According to William H.…

  15. High School Programming.

    ERIC Educational Resources Information Center

    Update on Gifted Education, 1992

    1992-01-01

    This theme issue covers "High School Programming" and approaches to meeting the needs of gifted high school students in Texas. The first article is "Thematic Interdisciplinary Curricula for Secondary Gifted Students in English and Social Studies" (Joel E. McIntosh and April W. Meacham). This approach is contrasted with the…

  16. Reforming Underperforming High Schools

    ERIC Educational Resources Information Center

    MDRC, 2013

    2013-01-01

    Urban high schools are in trouble--high dropout rates, low student academic achievement, and graduates who are unprepared for college are just some of the disappointing indicators. However, recent research points to a select number of approaches to improving student outcomes and reforming underperforming schools--from particular ways of creating…

  17. High-Conflict Divorce.

    ERIC Educational Resources Information Center

    Johnston, Janet R.

    1994-01-01

    Reviews available research studies of high-conflict divorce and its effects on children. Factors believed to contribute to high-conflict divorce are explored, and a model of their interrelationships is proposed. Dispute resolution, intervention, and prevention programs are discussed, and implications for social policy are outlined. (SLD)

  18. High Technology Training Surges.

    ERIC Educational Resources Information Center

    Gottlieb, Daniel

    1983-01-01

    Demand is intensifying for highly skilled workers qualified for jobs in high technology companies. Training (and retraining) for these jobs is being offered and supported by various groups/programs. Discusses cooperative and federal programs, internal retraining, contract training services, and vocational school training. Examples of such programs…

  19. High and Dry

    ERIC Educational Resources Information Center

    Johnson, Robert L.

    2005-01-01

    High-performance schools are facilities that improve the learning environment while saving energy, resources and money. Creating a high-performance school requires an integrated design approach. Key systems--including lighting, HVAC, electrical and plumbing--must be considered from the beginning of the design process. According to William H.…

  20. High coking value pitch

    DOEpatents

    Miller, Douglas J.; Chang, Ching-Feng; Lewis, Irwin C.; Lewis, Richard T.

    2014-06-10

    A high coking value pitch prepared from coal tar distillate and has a low softening point and a high carbon value while containing substantially no quinoline insolubles is disclosed. The pitch can be used as an impregnant or binder for producing carbon and graphite articles.

  1. High Blood Pressure (Hypertension)

    MedlinePlus

    ... For Consumers Consumer Information by Audience For Women High Blood Pressure (Hypertension) Share Tweet Linkedin Pin it More sharing ... En Español Who is at risk? How is high blood pressure treated? Understanding your blood pressure: What do the ...

  2. AIM High Program Manual.

    ERIC Educational Resources Information Center

    Austin Independent School District, TX.

    The AIM High Program was developed for elementary school children in the Austin (Texas) Independent School District who demonstrate unusually high ability, interest, and motivation in language arts, mathematics, science, and art. Students are identified for the program through standardized test scores, teacher recommendation, student interest,…

  3. Fixing High Schools

    ERIC Educational Resources Information Center

    Perkins-Gough, Deborah

    2005-01-01

    Reports from national education organizations in the US indicate the sorry state of high schools in the country that are accused of failing to adequately prepare their graduates for college or for the workforce, highlighting what is a serious problem in light of the troubled state of the US economy. The need to improve high schools is urgent and…

  4. High Functioning Autism.

    ERIC Educational Resources Information Center

    Reed, Vicki

    This paper reviews the characteristics and needs of students with high functioning autism. First, it lists 18 common characteristics of autism, then it stresses that autism is defined by the general pattern of characteristics. Next, it discusses how people with high functioning autism differ from those with autism. These differences include higher…

  5. High Energy Missile Project

    DTIC Science & Technology

    2004-12-01

    hypervelocity missile concept has been investigated. This research and development project called High Energy Missile (HEMi) technology...currently valid OMB control number. 1. REPORT DATE 00 DEC 2004 2. REPORT TYPE N/A 3. DATES COVERED - 4. TITLE AND SUBTITLE High Energy

  6. The American High School

    ERIC Educational Resources Information Center

    Ediger, Marlow

    2008-01-01

    Of all levels of schooling, the high school receives by far the most criticism. There are continuous innovations recommended in journal articles, textbooks, and speeches at state/national conventions on ways to improve the secondary level of schooling. At one teacher education convention, the speaker was criticizing the American high school and…

  7. High School: Erasing Borders

    ERIC Educational Resources Information Center

    Wright, Dianne; Bogotch, Ira

    2006-01-01

    Over the last several years there have been numerous calls for reforming high school to college transitions. In 2000-2001, the American Youth Policy Forum (AYPF) and the National Commission on the High School Senior Year respectively called for a re-thinking of how students moved from secondary to postsecondary education. A widely-discussed…

  8. High temperature superconductors

    NASA Technical Reports Server (NTRS)

    Wu, Maw-Kuen

    1987-01-01

    The two principle objectives are to develop materials that superconduct at higher temperatures and to better understand the mechanisms behind high temperature superconductivity. Experiments on the thermal reaction, structure, and physical properties of materials that exhibit superconductivity at high temperatures are discussed.

  9. The American High School

    ERIC Educational Resources Information Center

    Ediger, Marlow

    2008-01-01

    Of all levels of schooling, the high school receives by far the most criticism. There are continuous innovations recommended in journal articles, textbooks, and speeches at state/national conventions on ways to improve the secondary level of schooling. At one teacher education convention, the speaker was criticizing the American high school and…

  10. High temperature sensor

    DOEpatents

    Tokarz, Richard D.

    1982-01-01

    A high temperature sensor includes a pair of electrical conductors separated by a mass of electrical insulating material. The insulating material has a measurable resistivity within the sensor that changes in relation to the temperature of the insulating material within a high temperature range (1,000 to 2,000 K.). When required, the sensor can be encased within a ceramic protective coating.

  11. High School Oceanography.

    ERIC Educational Resources Information Center

    Falmouth Public Schools, MA.

    This book is a compilation of a series of papers designed to aid high school teachers in organizing a course in oceanography for high school students. It consists of twelve papers, with references, covering each of the following: (1) Introduction to Oceanography, (2) Geology of the Ocean, (3) The Continental Shelves, (4) Physical Properties of Sea…

  12. High altitude illness

    PubMed

    Hartman-Ksycińska, Anna; Kluz-Zawadzka, Jolanta; Lewandowski, Bogumił

    High-altitude illness is a result of prolonged high-altitude exposure of unacclimatized individuals. The illness is seen in the form of acute mountain sickness (AMS) which if not treated leads to potentially life-threatening high altitude pulmonary oedema and high-altitude cerebral oedema. Medical problems are caused by hypobaric hypoxia stimulating hypoxia-inducible factor (HIF) release. As a result, the central nervous system, circulation and respiratory system function impairment occurs. The most important factor in AMS treatment is acclimatization, withdrawing further ascent and rest or beginning to descent; oxygen supplementation, and pharmacological intervention, and, if available, a portable hyperbaric chamber. Because of the popularity of high-mountain sports and tourism better education of the population at risk is essential.

  13. High current high accuracy IGBT pulse generator

    SciTech Connect

    Nesterov, V.V.; Donaldson, A.R.

    1995-05-01

    A solid state pulse generator capable of delivering high current triangular or trapezoidal pulses into an inductive load has been developed at SLAC. Energy stored in a capacitor bank of the pulse generator is switched to the load through a pair of insulated gate bipolar transistors (IGBT). The circuit can then recover the remaining energy and transfer it back to the capacitor bank without reversing the capacitor voltage. A third IGBT device is employed to control the initial charge to the capacitor bank, a command charging technique, and to compensate for pulse to pulse power losses. The rack mounted pulse generator contains a 525 {mu}F capacitor bank. It can deliver 500 A at 900V into inductive loads up to 3 mH. The current amplitude and discharge time are controlled to 0.02% accuracy by a precision controller through the SLAC central computer system. This pulse generator drives a series pair of extraction dipoles.

  14. High redshift quasars and high metallicities

    NASA Technical Reports Server (NTRS)

    Ferland, Gary J.

    1997-01-01

    A large-scale code called Cloudy was designed to simulate non-equilibrium plasmas and predict their spectra. The goal was to apply it to studies of galactic and extragalactic emission line objects in order to reliably deduce abundances and luminosities. Quasars are of particular interest because they are the most luminous objects in the universe and the highest redshift objects that can be observed spectroscopically, and their emission lines can reveal the composition of the interstellar medium (ISM) of the universe when it was well under a billion years old. The lines are produced by warm (approximately 10(sup 4)K) gas with moderate to low density (n less than or equal to 10(sup 12) cm(sup -3)). Cloudy has been extended to include approximately 10(sup 4) resonance lines from the 495 possible stages of ionization of the lightest 30 elements, an extension that required several steps. The charge transfer database was expanded to complete the needed reactions between hydrogen and the first four ions and fit all reactions with a common approximation. Radiative recombination rate coefficients were derived for recombination from all closed shells, where this process should dominate. Analytical fits to Opacity Project (OP) and other recent photoionization cross sections were produced. Finally, rescaled OP oscillator strengths were used to compile a complete set of data for 5971 resonance lines. The major discovery has been that high redshift quasars have very high metallicities and there is strong evidence that the quasar phenomenon is associated with the birth of massive elliptical galaxies.

  15. Resource Utilization for Chemotherapy-Induced Nausea and Vomiting Events in Patients with Solid Tumors Treated with Antiemetic Regimens

    PubMed Central

    Schwartzberg, Lee; Harrow, Brooke; Lal, Lincy S.; Radtchenko, Janna; Lyman, Gary H.

    2015-01-01

    Background Chemotherapy-induced nausea and vomiting (CINV) can lead to increased emergency department visits and hospitalizations, which may contribute to increased cost of care. Antiemetic agents, such as neurokinin-1 (NK1) receptor antagonists and 5-hydroxytryptamine (5-HT3) receptor antagonists, are prescribed for patients receiving highly emetogenic chemotherapy (HEC) and moderately emetogenic chemotherapy (MEC). The current guidelines recommend a 3-drug combination of an NK1 receptor antagonist, a 5-HT3 receptor antagonist, and dexamethasone with HEC regimens and certain MEC regimens. Objective To compare the incidence of CINV and CINV-related resource utilization among patients who receive guideline-adherent HEC and MEC regimens and patients who receive non–guideline-adherent regimens. Methods In this retrospective, claims-based study, Inovalon's Medical Outcomes Research for Effectiveness and Economics Registry (MORE2 Registry) Research Edition database was used to identify 8089 patients with solid tumors receiving therapy with anthracycline plus cyclophosphamide (AC), cisplatin, or carboplatin from June 2013 to December 2013. The patients were stratified according to the use of an NK1 receptor antagonist regimen. International Classification of Diseases, Ninth Revision, Clinical Modification codes were used to identify CINV events associated with hospital, emergency department, and outpatient office visits among patients in the NK1 receptor antagonist group and the non-NK1 receptor antagonist group. Results A total of 1059 patients were included in the analysis, of whom 51% (N = 536) used an NK1 receptor antagonist–based regimen and 49% (N = 523) used non-NK1 receptor antagonist therapy. A higher percentage of patients receiving AC (73%) than cisplatin (56%) or carboplatin (23%) received an NK1 receptor antagonist. The incidence rates of total CINV events and CINV-related emergency department visits were lower in the group receiving an NK1 receptor

  16. High-pressure microfluidics

    NASA Astrophysics Data System (ADS)

    Hjort, K.

    2015-03-01

    When using appropriate materials and microfabrication techniques, with the small dimensions the mechanical stability of microstructured devices allows for processes at high pressures without loss in safety. The largest area of applications has been demonstrated in green chemistry and bioprocesses, where extraction, synthesis and analyses often excel at high densities and high temperatures. This is accessible through high pressures. Capillary chemistry has been used since long but, just like in low-pressure applications, there are several potential advantages in using microfluidic platforms, e.g., planar isothermal set-ups, large local variations in geometries, dense form factors, small dead volumes and precisely positioned microstructures for control of reactions, catalysis, mixing and separation. Other potential applications are in, e.g., microhydraulics, exploration, gas driven vehicles, and high-pressure science. From a review of the state-of-art and frontiers of high pressure microfluidics, the focus will be on different solutions demonstrated for microfluidic handling at high pressures and challenges that remain.

  17. High Altitude Pilgrimage Medicine

    PubMed Central

    2014-01-01

    Abstract Religious pilgrims have been going to high altitude pilgrimages long before trekkers and climbers sojourned in high altitude regions, but the medical literature about high altitude pilgrimage is sparse. Gosainkunda Lake (4300 m) near Kathmandu, Nepal, and Shri Amarnath Yatra (3800 m) in Sri Nagar, Kashmir, India, are the two sites in the Himalayas from where the majority of published reports of high altitude pilgrimage have originated. Almost all travels to high altitude pilgrimages are characterized by very rapid ascents by large congregations, leading to high rates of acute mountain sickness (AMS). In addition, epidemiological studies of pilgrims from Gosainkunda Lake show that some of the important risk factors for AMS in pilgrims are female sex and older age group. Studies based on the Shri Amarnath Yatra pilgrims show that coronary artery disease, complications of diabetes, and peptic ulcer disease are some of the common, important reasons for admission to hospital during the trip. In this review, the studies that have reported these and other relevant findings will be discussed and appropriate suggestions made to improve pilgrims' safety at high altitude. PMID:25330393

  18. High Speed Research Program

    NASA Technical Reports Server (NTRS)

    Anderson, Robert E.; Corsiglia, Victor R.; Schmitz, Frederic H. (Technical Monitor)

    1994-01-01

    An overview of the NASA High Speed Research Program will be presented from a NASA Headquarters perspective. The presentation will include the objectives of the program and an outline of major programmatic issues.

  19. High-Temperature Lubricants

    NASA Technical Reports Server (NTRS)

    1984-01-01

    In the early 1980's, Lewis Research Center began a program to develop high-temperature lubricants for use on future aircraft flying at three or more times the speed of sound, which can result in vehicle skin temperatures as high as 1,600 degrees Fahrenheit. A material that emerged from this research is a plasma-sprayed, self-lubricating metal- glass-fluoride coating able to reduce oxidation at very high temperatures. Technology is now in commercial use under the trade name Surf-Kote C-800, marketed by Hohman Plating and Manufacturing Inc. and manufactured under a patent license from NASA. Among its uses are lubrication for sliding contact bearings, shaft seals for turbopumps, piston rings for high performance compressors and hot glass processing machinery; it is also widely used in missile and space applications.

  20. High Throughput Testing

    NASA Astrophysics Data System (ADS)

    Marshall, A. H.; Buchness, R. K.; Schmunk, D. F.; Vasel, L. F.

    1982-06-01

    Several IFPA programs having large quantities of deliverable devices provided Rockwell with the necessity of solving the many problems associated with high volume production. The facility contains processing, assembly, and cryogenic testing equipment.

  1. High-voltage distributors

    NASA Technical Reports Server (NTRS)

    Mcchesney, J. F., Jr.

    1974-01-01

    Two distributors reduce high-voltage breakdowns and corona discharges. Both distributors are constructed to prevent air traps and facilitate servicing without soldering. Occurrence of coronas is also minimized due to smooth surfaces of device.

  2. High Velocity Gas Gun

    NASA Technical Reports Server (NTRS)

    1988-01-01

    A video tape related to orbital debris research is presented. The video tape covers the process of loading a High Velocity Gas Gun and firing it into a mounted metal plate. The process is then repeated in slow motion.

  3. High pressure furnace

    DOEpatents

    Morris, Donald E.

    1993-01-01

    A high temperature high pressure furnace has a hybrid partially externally heated construction. A metallic vessel fabricated from an alloy having a composition of at least 45% nickel, 15% chrome, and 10% tungsten is utilized (the preferred alloy including 55% nickel, 22% chrome, 14% tungsten, 2% molybdenum, 3% iron (maximum) and 5% cobalt (maximum). The disclosed alloy is fabricated into 11/4 or 2 inch, 32 mm or 50 mm bar stock and has a length of about 22 inches, 56 cm. This bar stock has an aperture formed therein to define a closed high temperature, high pressure oxygen chamber. The opposite and closed end of the vessel is provided with a small blind aperture into which a thermocouple can be inserted. The closed end of the vessel is inserted into an oven, preferably heated by standard nickel chrome electrical elements and having a heavily insulated exterior.

  4. High pressure oxygen furnace

    DOEpatents

    Morris, Donald E.

    1992-01-01

    A high temperature high pressure oxygen furnace having a hybrid partially externally heated construction is disclosed. A metallic bar fabricated from an alloy having a composition of at least 45% nickel, 15% chrome, and 10% tungsten is utilized (the preferred alloy including 55% nickel, 22% chrome, 14% tungsten, 2% molybdenum, 3% iron (maximum) and 5% cobalt (maximum). The disclosed alloy is fabricated into 11/4 inch bar stock and has a length of about 17 inches. This bar stock is gun drilled for over 16 inches of its length with 0.400 inch aperture to define a closed high temperature, high pressure oxygen chamber. The opposite and closed end of the bar is provided with a small support aperture into which both a support and a thermocouple can be inserted. The closed end of the gun drilled bar is inserted into an oven, preferably heated by standard nickel chrome electrical elements and having a heavily insulated exterior.

  5. High pressure oxygen furnace

    DOEpatents

    Morris, D.E.

    1992-07-14

    A high temperature high pressure oxygen furnace having a hybrid partially externally heated construction is disclosed. A metallic bar fabricated from an alloy having a composition of at least 45% nickel, 15% chrome, and 10% tungsten is utilized, the preferred alloy including 55% nickel, 22% chrome, 14% tungsten, 2% molybdenum, 3% iron (maximum) and 5% cobalt (maximum). The disclosed alloy is fabricated into 11/4 inch bar stock and has a length of about 17 inches. This bar stock is gun drilled for over 16 inches of its length with 0.400 inch aperture to define a closed high temperature, high pressure oxygen chamber. The opposite and closed end of the bar is provided with a small support aperture into which both a support and a thermocouple can be inserted. The closed end of the gun drilled bar is inserted into an oven, preferably heated by standard nickel chrome electrical elements and having a heavily insulated exterior. 5 figs.

  6. High pressure furnace

    DOEpatents

    Morris, D.E.

    1993-09-14

    A high temperature high pressure furnace has a hybrid partially externally heated construction. A metallic vessel fabricated from an alloy having a composition of at least 45% nickel, 15% chrome, and 10% tungsten is utilized (the preferred alloy including 55% nickel, 22% chrome, 14% tungsten, 2% molybdenum, 3% iron (maximum) and 5% cobalt (maximum)). The disclosed alloy is fabricated into 11/4 or 2 inch, 32 mm or 50 mm bar stock and has a length of about 22 inches, 56 cm. This bar stock has an aperture formed therein to define a closed high temperature, high pressure oxygen chamber. The opposite and closed end of the vessel is provided with a small blind aperture into which a thermocouple can be inserted. The closed end of the vessel is inserted into an oven, preferably heated by standard nickel chrome electrical elements and having a heavily insulated exterior. 19 figures.

  7. High-Speed Photography

    SciTech Connect

    Paisley, D.L.; Schelev, M.Y.

    1998-08-01

    The applications of high-speed photography to a diverse set of subjects including inertial confinement fusion, laser surgical procedures, communications, automotive airbags, lightning etc. are briefly discussed. (AIP) {copyright} {ital 1998 Society of Photo-Optical Instrumentation Engineers.}

  8. Diamond Ranch High School.

    ERIC Educational Resources Information Center

    Betsky, Aaron

    2000-01-01

    Highlights award-winning Diamond Ranch High School (California) that was designed and built on a steep site around Los Angeles considered unsatisfactory for building due to its unstable soils. Building organization is discussed, and photos are provided. (GR)

  9. High-mix insulins

    PubMed Central

    Kalra, Sanjay; Farooqi, Mohammad Hamed; El-Houni, Ali E.

    2015-01-01

    Premix insulins are commonly used insulin preparations, which are available in varying ratios of different molecules. These drugs contain one short- or rapid-acting, and one intermediate- or long-acting insulin. High-mix insulins are mixtures of insulins that contain 50% or more than 50% of short-acting insulin. This review describes the clinical pharmacology of high-mix insulins, including data from randomized controlled trials. It suggests various ways, in which high-mix insulin can be used, including once daily, twice daily, thrice daily, hetero-mix, and reverse regimes. The authors provide a rational framework to help diabetes care professionals, identify indications for pragmatic high-mix use. PMID:26425485

  10. High Redshift Quasars

    NASA Technical Reports Server (NTRS)

    Elvis, Martin S.

    1996-01-01

    The report for this period includes three papers: 'Associated Absorption at Low and High Redshift'; 'Strong X-ray Absorption in a Broad Absorption Line Quasar: PHL5200'; and 'ASCA and ROSAT X-ray Spectra of High-Redshift Radio-Loud Quasars'. The first gives examples from both low and high redshift for combining information on absorbing material in active galactic nuclei from both x-ray and the UV. The second presents ASCA observations of the z = 1.98 prototype broad absorption line quasar (BALQSO): PHL 5200, detected with both the solid-state imaging spectrometers and the gas imaging spectometers. The third paper presents results on the x-ray properties of 9 high-redshift radio-loud quasars observed by ASCA and ROSAT, including ASCA observations of S5 0014+81 (z = 3.38) and S5 0836+71 (z = 2.17) and ROSAT observations of PKS 2126-158.

  11. High-Temperature Superconductivity

    SciTech Connect

    Peter Johnson

    2008-11-05

    Like astronomers tweaking images to gain a more detailed glimpse of distant stars, physicists at Brookhaven National Laboratory have found ways to sharpen images of the energy spectra in high-temperature superconductors — materials that carry electrical c

  12. High Power Hall Thrusters

    NASA Technical Reports Server (NTRS)

    Jankovsky, Robert; Tverdokhlebov, Sergery; Manzella, David

    1999-01-01

    The development of Hall thrusters with powers ranging from tens of kilowatts to in excess of one hundred kilowatts is considered based on renewed interest in high power. high thrust electric propulsion applications. An approach to develop such thrusters based on previous experience is discussed. It is shown that the previous experimental data taken with thrusters of 10 kW input power and less can be used. Potential mass savings due to the design of high power Hall thrusters are discussed. Both xenon and alternate thruster propellant are considered, as are technological issues that will challenge the design of high power Hall thrusters. Finally, the implications of such a development effort with regard to ground testing and spacecraft intecrati'on issues are discussed.

  13. High power laser dump

    NASA Astrophysics Data System (ADS)

    Hsu, M. S.; Hsu, J. P.

    1985-08-01

    A high power laser dump has defined laser beam introduction angles to the internal surface of a cylinder to maximize energy dispersion and absorption and, has two zones formed of distinctive reflective and absorbing materials.

  14. High School Parking Lots.

    ERIC Educational Resources Information Center

    Neff, Thomas G.

    2002-01-01

    Describes the reorganization of the site of Ben Davis High School in Wayne Township, Indiana as an example of improvements to school parking lot design and vehicle/pedestrian traffic flow and security. Includes design drawings. (EV)

  15. High Velocity Gas Gun

    NASA Technical Reports Server (NTRS)

    1988-01-01

    A video tape related to orbital debris research is presented. The video tape covers the process of loading a High Velocity Gas Gun and firing it into a mounted metal plate. The process is then repeated in slow motion.

  16. High cholesterol - children

    MedlinePlus

    ... and dressings Avoid foods that are high in saturated fat and added sugar Use skim milk or low- ... with other risk factors. Have family history of cardiovascular disease. Have one or more risk factors for ...

  17. High-Definition Medicine.

    PubMed

    Torkamani, Ali; Andersen, Kristian G; Steinhubl, Steven R; Topol, Eric J

    2017-08-24

    The foundation for a new era of data-driven medicine has been set by recent technological advances that enable the assessment and management of human health at an unprecedented level of resolution-what we refer to as high-definition medicine. Our ability to assess human health in high definition is enabled, in part, by advances in DNA sequencing, physiological and environmental monitoring, advanced imaging, and behavioral tracking. Our ability to understand and act upon these observations at equally high precision is driven by advances in genome editing, cellular reprogramming, tissue engineering, and information technologies, especially artificial intelligence. In this review, we will examine the core disciplines that enable high-definition medicine and project how these technologies will alter the future of medicine. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Diamond Ranch High School.

    ERIC Educational Resources Information Center

    Betsky, Aaron

    2000-01-01

    Highlights award-winning Diamond Ranch High School (California) that was designed and built on a steep site around Los Angeles considered unsatisfactory for building due to its unstable soils. Building organization is discussed, and photos are provided. (GR)

  19. High blood pressure medicines

    MedlinePlus

    Hypertension - medicines ... blood vessel diseases. You may need to take medicines to lower your blood pressure if lifestyle changes ... blood pressure to the target level. WHEN ARE MEDICINES FOR HIGH BLOOD PRESSURE USED Most of the ...

  20. High Energy Continuum of High Redshift Quasars

    NASA Technical Reports Server (NTRS)

    Elvis, Martin

    2000-01-01

    Discussion with the RXTE team at GSFC showed that a sufficiently accurate background subtraction procedure had now, been derived for sources at the flux level of PKS 2126-158. However this solution does not apply to observations carried out before April 1997, including our observation. The prospect of an improved solution becoming available soon is slim. As a result the RXTE team agreed to re-observe PKS2126-158. The new observation was carried out in April 1999. Quasi-simultaneous optical observations were obtained, as Service observing., at the 4-meter Anglo-Australian Telescope, and ftp-ed from the AAT on 22April. The RXTE data was processed in late June, arriving at SAO in early July. Coincidentally, our collaborative Beppo-SAX observation of PKS2126-158 was made later in 1999, and a GTO Chandra observation (with which we are involved) was made on November 16. Since this gives us a unique monitoring data for a high redshift quasar over a broad pass-band we are now combining all three observations into a single comprehensive study Final publication of the RXTE data will thus take place under another grant.

  1. Jupiter Exploration: High Risk and High Rewards

    NASA Astrophysics Data System (ADS)

    Kite, Edwin S.

    2004-12-01

    Jupiter exploration is big science, and only the United States can afford self-contained missions to the gas giant and its four planet-sized moons. The Galileo spacecraft, which was recently flown into Jupiter to prevent it from contaminating Europa's ocean, cost $1.6 billion. Despite the failure of its High Gain Antenna (HGA), Galileo discovered briny, subsurface oceans on Europa, Ganymede, and Callisto; globally mapped all four Galilean moons; monitored Io's volcanic activity; carried out a 7-year study of the Jovian magnetosphere; and dropped an atmospheric probe into Jupiter's upper cloud layer. Of these achievements, the most significant is the indirect detection of a deep subsurface liquid-water layer on Europa [Pappalardo et al., 1999; Kivelson et al., 2000]. The case for a Europan ecosystem can be made [e.g., Marion et al., 2004], although it is important to remember the energetic and biogeochemical limits on putative Europan life [e.g., Soare et al., 2002]. Europa's low moment of inertia (0.346 +/- 0.005 MR2) suggests a silicate mantle below the ocean, permitting chemical exchanges between ocean and silicates, as occurs on Earth. Europa's surface is geologically young, likely emplaced 20-180 million years ago. Any recycling of surficial icy crust into the ocean could add oxygen, sulfur, and organic compounds, either impact-delivered or generated in situ by UV irradiation and the implantation of ionized particles from Jupiter's radiation belts.

  2. High efficiency incandescent lighting

    SciTech Connect

    Bermel, Peter; Ilic, Ognjen; Chan, Walker R.; Musabeyoglu, Ahmet; Cukierman, Aviv Ruben; Harradon, Michael Robert; Celanovic, Ivan; Soljacic, Marin

    2014-09-02

    Incandescent lighting structure. The structure includes a thermal emitter that can, but does not have to, include a first photonic crystal on its surface to tailor thermal emission coupled to, in a high-view-factor geometry, a second photonic filter selected to reflect infrared radiation back to the emitter while passing visible light. This structure is highly efficient as compared to standard incandescent light bulbs.

  3. High Gradient Induction Cell

    SciTech Connect

    Caporaso, G J

    2004-11-29

    A concept being developed for high current electron beams may have application to HEDP and is described here. It involves the use of planar Blumlein stacks placed inside an induction cell. The output end of the Blumlein stack is applied across a high gradient insulator (HGI). These insulators have been used successfully in the presence of kilo Ampere-level electron beam currents for tens of nanoseconds at gradients of 20 MV/meter.

  4. High latitude scintillations

    NASA Astrophysics Data System (ADS)

    Basu, Santimay; Basu, Sunanda

    High-latitude phase and amplitude scintillations have been observed with quasi-geostationary polar beacon satellites, high-altitude orbiting GPS satellites, and low-altitude orbiting HiLat and Polar Bear satellites. The scintillation behavior observed in the polar cap, cusp, and nightside auroral oval is described. Consideration is given to the possible mechanisms for the generation of irregularities that cause scintillations. The importance of coordinated multitechnique measurements for scintillation studies is stressed.

  5. High-temperature electronics

    NASA Technical Reports Server (NTRS)

    Matus, Lawrence G.; Seng, Gary T.

    1990-01-01

    To meet the needs of the aerospace propulsion and space power communities, the high temperature electronics program at the Lewis Research Center is developing silicon carbide (SiC) as a high temperature semiconductor material. This program supports a major element of the Center's mission - to perform basic and developmental research aimed at improving aerospace propulsion systems. Research is focused on developing the crystal growth, characterization, and device fabrication technologies necessary to produce a family of SiC devices.

  6. High Power Switch Development.

    DTIC Science & Technology

    1979-11-29

    LUBBOCK Unclassified SECURITY €! ION 0 THIS PAGE (When Doat Entered) E RT DOCUMENTATION PAGE READ INSTRUCTONS9 . , -- RBEFORE COMPLETIDG FORM off...investigations, we used the electrodes in an Ion Physics Corp. FX-15 generator made available to us by the AFWL. Considerable modifications were necessary...the high pressure vessel of such as fusion, the production of high energy- the Ion Physics Corporation FX-15 (Fig 2). The particle beams, and the

  7. High Resolution Computed Tomography

    DTIC Science & Technology

    1992-07-31

    samples. 14. SUBJECTTERMS 15. NUMBER OF PAGES 38 High Resolution, Microfocus , Characterization, X - Ray , Micrography, Computed Tomography (CT), Failure...high resolutions (50 g.tm feature sensitivity) when a small field of view (50 mm) is used [11]. Specially designed detectors and a microfocus X - ray ...Wright Laboratories. Feldkamp [14] at Ford used a microfocus X - ray source and an X - ray image intensifier to develop a system capable of 20 g.m

  8. HIGH TEMPERATURE THERMOCOUPLE

    DOEpatents

    Eshayu, A.M.

    1963-02-12

    This invention contemplates a high temperature thermocouple for use in an inert or a reducing atmosphere. The thermocouple limbs are made of rhenium and graphite and these limbs are connected at their hot ends in compressed removable contact. The rhenium and graphite are of high purity and are substantially stable and free from diffusion into each other even without shielding. Also, the graphite may be thick enough to support the thermocouple in a gas stream. (AEC)

  9. High performance polymeric foams

    SciTech Connect

    Gargiulo, M.; Sorrentino, L.; Iannace, S.

    2008-08-28

    The aim of this work was to investigate the foamability of high-performance polymers (polyethersulfone, polyphenylsulfone, polyetherimide and polyethylenenaphtalate). Two different methods have been used to prepare the foam samples: high temperature expansion and two-stage batch process. The effects of processing parameters (saturation time and pressure, foaming temperature) on the densities and microcellular structures of these foams were analyzed by using scanning electron microscopy.

  10. High intensity neutrino beams

    SciTech Connect

    Ichikawa, A. K.

    2015-07-15

    High-intensity proton accelerator complex enabled long baseline neutrino oscillation experiments with a precisely controlled neutrino beam. The beam power so far achieved is a few hundred kW with enourmorous efforts of accelerator physicists and engineers. However, to fully understand the lepton mixing structure, MW-class accelerators are desired. We describe the current intensity-frontier high-energy proton accelerators, their plans to go beyond and technical challenges in the neutrino beamline facilities.

  11. High-temperature sensor

    DOEpatents

    Not Available

    1981-01-29

    A high temperature sensor is described which includes a pair of electrical conductors separated by a mass of electrical insulating material. The insulating material has a measurable resistivity within the sensor that changes in relation to the temperature of the insulating material within a high temperature range (1000 to 2000/sup 0/K). When required, the sensor can be encased within a ceramic protective coating.

  12. High Performance Polymers

    NASA Technical Reports Server (NTRS)

    Venumbaka, Sreenivasulu R.; Cassidy, Patrick E.

    2003-01-01

    This report summarizes results from research on high performance polymers. The research areas proposed in this report include: 1) Effort to improve the synthesis and to understand and replicate the dielectric behavior of 6HC17-PEK; 2) Continue preparation and evaluation of flexible, low dielectric silicon- and fluorine- containing polymers with improved toughness; and 3) Synthesis and characterization of high performance polymers containing the spirodilactam moiety.

  13. High temperature pressure gauge

    DOEpatents

    Echtler, J. Paul; Scandrol, Roy O.

    1981-01-01

    A high temperature pressure gauge comprising a pressure gauge positioned in fluid communication with one end of a conduit which has a diaphragm mounted in its other end. The conduit is filled with a low melting metal alloy above the diaphragm for a portion of its length with a high temperature fluid being positioned in the remaining length of the conduit and in the pressure gauge.

  14. High conductivity composite metal

    DOEpatents

    Zhou, Ruoyi; Smith, James L.; Embury, John David

    1998-01-01

    Electrical conductors and methods of producing them, where the conductors possess both high strength and high conductivity. Conductors are comprised of carbon steel and a material chosen from a group consisting of copper, nickel, silver, and gold. Diffusion barriers are placed between these two materials. The components of a conductor are assembled and then the assembly is subjected to heat treating and mechanical deformation steps.

  15. High conductivity composite metal

    DOEpatents

    Zhou, R.; Smith, J.L.; Embury, J.D.

    1998-01-06

    Electrical conductors and methods of producing them are disclosed, where the conductors possess both high strength and high conductivity. Conductors are comprised of carbon steel and a material chosen from a group consisting of copper, nickel, silver, and gold. Diffusion barriers are placed between these two materials. The components of a conductor are assembled and then the assembly is subjected to heat treating and mechanical deformation steps. 10 figs.

  16. High Gradient Accelerator Research

    SciTech Connect

    Temkin, Richard

    2016-07-12

    The goal of the MIT program of research on high gradient acceleration is the development of advanced acceleration concepts that lead to a practical and affordable next generation linear collider at the TeV energy level. Other applications, which are more near-term, include accelerators for materials processing; medicine; defense; mining; security; and inspection. The specific goals of the MIT program are: • Pioneering theoretical research on advanced structures for high gradient acceleration, including photonic structures and metamaterial structures; evaluation of the wakefields in these advanced structures • Experimental research to demonstrate the properties of advanced structures both in low-power microwave cold test and high-power, high-gradient test at megawatt power levels • Experimental research on microwave breakdown at high gradient including studies of breakdown phenomena induced by RF electric fields and RF magnetic fields; development of new diagnostics of the breakdown process • Theoretical research on the physics and engineering features of RF vacuum breakdown • Maintaining and improving the Haimson / MIT 17 GHz accelerator, the highest frequency operational accelerator in the world, a unique facility for accelerator research • Providing the Haimson / MIT 17 GHz accelerator facility as a facility for outside users • Active participation in the US DOE program of High Gradient Collaboration, including joint work with SLAC and with Los Alamos National Laboratory; participation of MIT students in research at the national laboratories • Training the next generation of Ph. D. students in the field of accelerator physics.

  17. High power density targets

    NASA Astrophysics Data System (ADS)

    Pellemoine, Frederique

    2013-12-01

    In the context of new generation rare isotope beam facilities based on high-power heavy-ion accelerators and in-flight separation of the reaction products, the design of the rare isotope production targets is a major challenge. In order to provide high-purity beams for science, high resolution is required in the rare isotope separation. This demands a small beam spot on the production target which, together with the short range of heavy ions in matter, leads to very high power densities inside the target material. This paper gives an overview of the challenges associated with this high power density, discusses radiation damage issues in targets exposed to heavy ion beams, and presents recent developments to meet some of these challenges through different projects: FAIR, RIBF and FRIB which is the most challenging. Extensive use of Finite Element Analysis (FEA) has been made at all facilities to specify critical target parameters and R&D work at FRIB successfully retired two major risks related to high-power density and heavy-ion induced radiation damage.

  18. Ca(2+) signaling and emesis: Recent progress and new perspectives.

    PubMed

    Zhong, Weixia; Picca, Andrew J; Lee, Albert S; Darmani, Nissar A

    2017-01-01

    Cisplatin-like chemotherapeutics cause vomiting via calcium (Ca(2+))-dependent release of multiple neurotransmitters (dopamine, serotonin, substance P, etc.) from the gastrointestinal enterochromaffin cells and/or the brainstem. Intracellular Ca(2+) signaling is triggered by activation of diverse emetic receptors (including tachykininergic NK1, serotonergic 5-HT3, dopaminergic D2, cholinergic M1, or histaminergic H1), whose activation in vomit-competent species can evoke emesis. Other emetogens such as cisplatin, rotavirus NSP4 protein and bacterial toxins can also induce intracellular Ca(2+) elevation. Netupitant is a highly selective neurokinin NK1 receptor (NK1R) antagonist and palonosetron is a selective second-generation serotonin 5-HT3 receptor (5-HT3R) antagonist with a distinct pharmacological profile. An oral fixed combination of netupitant/palonosetron (NEPA; Akynzeo(®)) with >85% antiemetic efficacy is available for use in the prevention of acute and delayed chemotherapy-induced nausea and vomiting (CINV). Cannabinoid CB1 receptor agonists possess broad-spectrum antiemetic activity since they prevent vomiting caused by a variety of emetic stimuli including the chemotherapeutic agent cisplatin, 5-HT3R agonists, and D2R agonists. Our findings demonstrate that application of the L-type Ca(2+) channel (LTCC) agonist FPL 64176 and the intracellular Ca(2+) mobilizing agent thapsigargin (a sarco/endoplasmic reticulum Ca(2+)-ATPase inhibitor) cause vomiting in the least shrew. On the other hand, blockade of LTCCs by corresponding antagonists (nifedipine or amlodipine) not only provide broad-spectrum antiemetic efficacy against diverse agents that specifically activate emetogenic receptors such as 5-HT3, NK1, D2, and M1 receptors, but can also potentiate the antiemetic efficacy of palonosetron against the non-specific emetogen, cisplatin. In this review, we will provide an overview of Ca(2+) involvement in the emetic process; discuss the relationship between Ca

  19. High Performance Arcjet Engines

    NASA Technical Reports Server (NTRS)

    Kennel, Elliot B.; Ivanov, Alexey Nikolayevich; Nikolayev, Yuri Vyacheslavovich

    1994-01-01

    This effort sought to exploit advanced single crystal tungsten-tantalum alloy material for fabrication of a high strength, high temperature arcjet anode. The use of this material is expected to result in improved strength, temperature resistance, and lifetime compared to state of the art polycrystalline alloys. In addition, the use of high electrical and thermal conductivity carbon-carbon composites was considered, and is believed to be a feasible approach. Highly conductive carbon-carbon composite anode capability represents enabling technology for rotating-arc designs derived from the Russian Scientific Research Institute of Thermal Processes (NIITP) because of high heat fluxes at the anode surface. However, for US designs the anode heat flux is much smaller, and thus the benefits are not as great as in the case of NIITP-derived designs. Still, it does appear that the tensile properties of carbon-carbon can be even better than those of single crystal tungsten alloys, especially when nearly-single-crystal fibers such as vapor grown carbon fiber (VGCF) are used. Composites fabricated from such materials must be coated with a refractory carbide coating in order to ensure compatibility with high temperature hydrogen. Fabrication of tungsten alloy single crystals in the sizes required for fabrication of an arcjet anode has been shown to be feasible. Test data indicate that the material can be expected to be at least the equal of W-Re-HfC polycrystalline alloy in terms of its tensile properties, and possibly superior. We are also informed by our colleagues at Scientific Production Association Luch (NP0 Luch) that it is possible to use Russian technology to fabricate polycrystalline W-Re-HfC or other high strength alloys if desired. This is important because existing engines must rely on previously accumulated stocks of these materials, and a fabrication capability for future requirements is not assured.

  20. High Temperature Capacitor Development

    SciTech Connect

    John Kosek

    2009-06-30

    The absence of high-temperature electronics is an obstacle to the development of untapped energy resources (deep oil, gas and geothermal). US natural gas consumption is projected to grow from 22 trillion cubic feet per year (tcf) in 1999 to 34 tcf in 2020. Cumulatively this is 607 tcf of consumption by 2020, while recoverable reserves using current technology are 177 tcf. A significant portion of this shortfall may be met by tapping deep gas reservoirs. Tapping these reservoirs represents a significant technical challenge. At these depths, temperatures and pressures are very high and may require penetrating very hard rock. Logistics of supporting 6.1 km (20,000 ft) drill strings and the drilling processes are complex and expensive. At these depths up to 50% of the total drilling cost may be in the last 10% of the well depth. Thus, as wells go deeper it is increasingly important that drillers are able to monitor conditions down-hole such as temperature, pressure, heading, etc. Commercial off-the-shelf electronics are not specified to meet these operating conditions. This is due to problems associated with all aspects of the electronics including the resistors and capacitors. With respect to capacitors, increasing temperature often significantly changes capacitance because of the strong temperature dependence of the dielectric constant. Higher temperatures also affect the equivalent series resistance (ESR). High-temperature capacitors usually have low capacitance values because of these dielectric effects and because packages are kept small to prevent mechanical breakage caused by thermal stresses. Electrolytic capacitors do not operate at temperatures above 150oC due to dielectric breakdown. The development of high-temperature capacitors to be used in a high-pressure high-temperature (HPHT) drilling environment was investigated. These capacitors were based on a previously developed high-voltage hybridized capacitor developed at Giner, Inc. in conjunction with a

  1. High availability using virtualization

    NASA Astrophysics Data System (ADS)

    Calzolari, Federico

    2009-10-01

    High availability has always been one of the main problems for a data center. Till now high availability was achieved by host per host redundancy, a highly expensive method in terms of hardware and human costs. A new approach to the problem can be offered by virtualization. Using virtualization, it is possible to achieve a redundancy system for all the services running on a data center. This new approach to high availability allows to share the running virtual machines over the servers up and running, by exploiting the features of the virtualization layer: start, stop and move virtual machines between physical hosts. The system (3RC) is based on a finite state machine with hysteresis, providing the possibility to restart each virtual machine over any physical host, or reinstall it from scratch. A complete infrastructure has been developed to install operating system and middleware in a few minutes. To virtualize the main servers of a data center, a new procedure has been developed to migrate physical to virtual hosts. The whole Grid data center SNS-PISA is running at the moment in virtual environment under the high availability system. As extension of the 3RC architecture, several storage solutions have been tested to store and centralize all the virtual disks, from NAS to SAN, to grant data safety and access from everywhere. Exploiting virtualization and ability to automatically reinstall a host, we provide a sort of host on-demand, where the action on a virtual machine is performed only when a disaster occurs.

  2. High availability using virtualization

    NASA Astrophysics Data System (ADS)

    Calzolari, Federico; Arezzini, Silvia; Ciampa, Alberto; Mazzoni, Enrico; Domenici, Andrea; Vaglini, Gigliola

    2010-04-01

    High availability has always been one of the main problems for a data center. Till now high availability was achieved by host per host redundancy, a highly expensive method in terms of hardware and human costs. A new approach to the problem can be offered by virtualization. Using virtualization, it is possible to achieve a redundancy system for all the services running on a data center. This new approach to high availability allows the running virtual machines to be distributed over a small number of servers, by exploiting the features of the virtualization layer: start, stop and move virtual machines between physical hosts. The 3RC system is based on a finite state machine, providing the possibility to restart each virtual machine over any physical host, or reinstall it from scratch. A complete infrastructure has been developed to install operating system and middleware in a few minutes. To virtualize the main servers of a data center, a new procedure has been developed to migrate physical to virtual hosts. The whole Grid data center SNS-PISA is running at the moment in virtual environment under the high availability system.

  3. High temperature storage loop :

    SciTech Connect

    Gill, David Dennis; Kolb, William J.

    2013-07-01

    A three year plan for thermal energy storage (TES) research was created at Sandia National Laboratories in the spring of 2012. This plan included a strategic goal of providing test capability for Sandia and for the nation in which to evaluate high temperature storage (>650ÀC) technology. The plan was to scope, design, and build a flow loop that would be compatible with a multitude of high temperature heat transfer/storage fluids. The High Temperature Storage Loop (HTSL) would be reconfigurable so that it was useful for not only storage testing, but also for high temperature receiver testing and high efficiency power cycle testing as well. In that way, HTSL was part of a much larger strategy for Sandia to provide a research and testing platform that would be integral for the evaluation of individual technologies funded under the SunShot program. DOEs SunShot program seeks to reduce the price of solar technologies to 6/kWhr to be cost competitive with carbon-based fuels. The HTSL project sought to provide evaluation capability for these SunShot supported technologies. This report includes the scoping, design, and budgetary costing aspects of this effort

  4. SDC at high luminosity

    SciTech Connect

    Green, D.

    1990-05-01

    Why is it prudent to plan for a luminosity (L) of >10{sup 34}/(cm{sup 2}sec) from the beginning First, the SSC is easily capable of attaining high luminosity. In comparison, for {bar p}p machines such as the Tevatron, increases in L are difficult. Second, after early runs at design luminosity, the only simple upgrade to a general purpose detector is an increase in luminosity. Third, and most important, the only known model independent physics goal of SSC is in the electroweak sector; the ZZ scattering amplitude reaches the unitarity bound for {radical}{cflx s} {approx equal} 3 TeV. In order to reach this mass range, and assure that some new physics is found, high luminosity running is needed. Since high luminosity running is desirable and easily attainable, it is inevitable. Therefore, one should build the hooks'' for upgrades to high L into the SDC from the beginning. The experience of CDF is that if this is not done, upgrades can be painful. Specifically, if possible, SDC should make sure that the chosen technologies allow high L operation. The time to plan for the whole useful lifetime of SDC is from the beginning. 9 refs., 6 figs.

  5. High Altitude Medical Problems

    PubMed Central

    Hultgren, Herbert N.

    1979-01-01

    Increased travel to high altitude areas by mountaineers and nonclimbing tourists has emphasized the clinical problems associated with rapid ascent. Acute mountain sickness affects most sojourners at elevations above 10,000 feet. Symptoms are usually worse on the second or third day after arrival. Gradual ascent, spending one to three days at an intermediate altitude, and the use of acetazolamide (Diamox) will prevent or ameliorate symptoms in most instances. Serious and potentially fatal problems, such as high altitude pulmonary edema or cerebral edema, occur in approximately 0.5 percent to 1.0 percent of visitors to elevations above 10,000 feet—especially with heavy physical exertion on arrival, such as climbing or skiing. Early recognition, high flow oxygen therapy and prompt descent are crucially important in management. Our knowledge of the causes of these and other high altitude problems, such as retinal hemorrhage, systemic edema and pulmonary hypertension, is still incomplete. Even less is known of the effect of high altitudes on medical conditions common at sea level or on the action of commonly used drugs. ImagesFigure 2. PMID:483805

  6. High-altitude medicine

    PubMed Central

    Paralikar, Swapnil J.; Paralikar, Jagdish H.

    2010-01-01

    Sojourns to high altitude have become common for recreation and adventure purposes. In most individuals, gradual ascent to a high altitude leads to a series of adaptive changes in the body, termed as acclimatization. These include changes in the respiratory, cardiovascular, hematologic systems and cellular adaptations that enhance oxygen delivery to the tissues and augment oxygen uptake. Thus there is an increase in pulmonary ventilation, increase in diffusing capacity in the lung, an increase in the cardiac output and increase in the red blood cell count due to an increase in erythropoietin secretion by the kidney, all of which enhance oxygen delivery to the cells. Cellular changes like increase in the number of mitochondria and augmentation of cytochrome oxidase systems take months or years to develop. Too rapid an ascent or inability to acclimatize leads to high-altitude illnesses. These include acute mountain sickness (AMS), high-altitude cerebral edema (HACE) and high-altitude pulmonary edema (HAPE). Acute mountain sickness is self limiting if recognized early. Both HACE and HAPE are life threatening and need to be treated aggressively. The key to treatment of these illnesses is early recognition; administration of supplemental oxygen; and descent if required. Drugs like acetazolamide, dexamethasone, nifedipine may be administered as recommended. PMID:20808661

  7. Platinum-based Chemotherapy in Primary Advanced Seminoma—a Retrospective Analysis: Treatment Results at the Northern Israel Oncology Center (1989–2010)

    PubMed Central

    Stein, Moshe E.; Drumea, Karen; Charas, Tomer; Gershuny, Anthony; Ben-Yosef, Rahamim

    2014-01-01

    Objective: Over the past 30 years, great strides have been made in the treatment of disseminated testicular tumors. Despite the low number of patients and the rarity of studies concerning primary advanced seminoma, the efficacy of chemotherapy is clear, mainly 3–4-cisplatin-based chemotherapy. Aiming to contribute to the understanding and implementation of proper chemotherapeutic management in advanced seminoma patients, we retrospectively summarized our experience with 26 patients who were referred for platinum-based chemotherapy, post-orchiectomy to the Northern Israel Oncology Center between 1989 and 2010. Response rate, side effects, and long-term outcome were investigated. Methods: Before chemotherapy, meticulous staging was done, including tumor markers (B-human chorionic gonadotropin (B-HCG), alpha-fetoprotein (AFP), and lactic dehydrogenase (LDH)), and abdominal and pelvic computerized tomography (CT) scans were carried out. Results: All 26 treated patients achieved complete remission, clinically and symptomatically, with normalization of their CT scans. At a median follow-up of 120 months (range, 24–268 months) all patients are alive, without evidence of recurrent disease. One patient whose disease recurred twice achieved a third complete remission following salvage treatment with high-dose chemotherapy and autologous peripheral stem cell transplantation. Another patient, who preferred surveillance, relapsed abdominally after 9 months but achieved long-standing complete remission with cisplatin-based chemotherapy. Both these patients are alive with no evidence of disease. Three patients recovered uneventfully from bleomycin-induced pneumonitis. Conclusions: Advanced seminoma is a highly curable disease using platinum-based chemotherapy. Our study confirms the efficacy and safety of cisplatin-based chemotherapy in the treatment of advanced seminoma. PMID:24498512

  8. Efficient carboplatin single therapy in a mouse model of human testicular nonseminomatous germ cell tumor.

    PubMed

    Aharinejad, Seyedhossein; Fink, Melanie; Abri, Hojatollah; Nedwed, Stephan; Schlag, Michael G; Macfelda, Karin; Abraham, Dietmar; Miksovsky, Aurelia; Höltl, Eva; Höltl, Wolfgang

    2002-01-01

    Cisplatin based combination therapy has shown excellent clinical results in patients with testicular nonseminomatous germ cell tumor but chemotherapy induced morbidity and reduced patient compliance are limiting factors in this regimen. To decrease cisplatin based combination therapy induced morbidity we examined carboplatin versus etoposide single therapy in an animal model. A total of 180 SCID mice bearing testicular nonseminomatous germ cell tumor xenografts received 120 mg./kg. carboplatin as a single cycle, 60 or 30 mg./kg. carboplatin cycled twice, 80, 50 or 30 mg./kg. etoposide cycled twice, or Ringer solution as the control. An additional 20 sham treated and 20 untreated mice also served as controls. Histological and immunocytochemical testing, in vivo microscopy, vascular corrosion casting, serum tumor markers, complete blood count and real-time polymerase chain reaction were used to monitor therapy efficacy. Carboplatin at 60 mg./kg. cycled twice eradicated the tumor and significantly reduced vascular density and vascular endothelial growth factor-A messenger RNA (p <0.05). Elevated tumor markers returned to baseline after carboplatin administration. Therapy was well tolerated, resulting thrombocytopenia disappeared 6 weeks after therapy and the animals were tumor-free 6 months after treatment. Although 120 mg./kg. carboplatin eradicated the tumor, it resulted in extensive mortality and morbidity. Single treatment 30, 50 and 80 mg./kg. etoposide failed. Carboplatin single therapy was highly effective in our nonseminomatous germ cell tumor model and it may be examined in future clinical trials in patients with high risk stage I nonseminomatous germ cell cancer for reducing cisplatin based combination therapy induced morbidity. Vascular density and vascular endothelial growth factor messenger RNA were elevated in our animal model and deserve further study in nonseminomatous germ cell tumor cases as potential risk factors.

  9. High Performance, Dependable Multiprocessor

    NASA Technical Reports Server (NTRS)

    Ramos, Jeremy; Samson, John R.; Troxel, Ian; Subramaniyan, Rajagopal; Jacobs, Adam; Greco, James; Cieslewski, Grzegorz; Curreri, John; Fischer, Michael; Grobelny, Eric; George, Alan; Aggarwal, Vikas; Patel, Minesh; Some, Raphael

    2006-01-01

    With the ever increasing demand for higher bandwidth and processing capacity of today's space exploration, space science, and defense missions, the ability to efficiently apply commercial-off-the-shelf (COTS) processors for on-board computing is now a critical need. In response to this need, NASA's New Millennium Program office has commissioned the development of Dependable Multiprocessor (DM) technology for use in payload and robotic missions. The Dependable Multiprocessor technology is a COTS-based, power efficient, high performance, highly dependable, fault tolerant cluster computer. To date, Honeywell has successfully demonstrated a TRL4 prototype of the Dependable Multiprocessor [I], and is now working on the development of a TRLS prototype. For the present effort Honeywell has teamed up with the University of Florida's High-performance Computing and Simulation (HCS) Lab, and together the team has demonstrated major elements of the Dependable Multiprocessor TRLS system.

  10. High-energy detector

    DOEpatents

    Bolotnikov, Aleksey E [South Setauket, NY; Camarda, Giuseppe [Farmingville, NY; Cui, Yonggang [Upton, NY; James, Ralph B [Ridge, NY

    2011-11-22

    The preferred embodiments are directed to a high-energy detector that is electrically shielded using an anode, a cathode, and a conducting shield to substantially reduce or eliminate electrically unshielded area. The anode and the cathode are disposed at opposite ends of the detector and the conducting shield substantially surrounds at least a portion of the longitudinal surface of the detector. The conducting shield extends longitudinally to the anode end of the detector and substantially surrounds at least a portion of the detector. Signals read from one or more of the anode, cathode, and conducting shield can be used to determine the number of electrons that are liberated as a result of high-energy particles impinge on the detector. A correction technique can be implemented to correct for liberated electron that become trapped to improve the energy resolution of the high-energy detectors disclosed herein.

  11. High temperature interface superconductivity

    DOE PAGES

    Gozar, A.; Bozovic, I.

    2016-01-20

    High-Tc superconductivity at interfaces has a history of more than a couple of decades. In this review we focus our attention on copper-oxide based heterostructures and multi-layers. We first discuss the technique, atomic layer-by-layer molecular beam epitaxy (ALL-MBE) engineering, that enabled High-Tc Interface Superconductivity (HT-IS), and the challenges associated with the realization of high quality interfaces. Then we turn our attention to the experiments which shed light on the structure and properties of interfacial layers, allowing comparison to those of single-phase films and bulk crystals. Both ‘passive’ hetero-structures as well as surface-induced effects by external gating are discussed. Here, wemore » conclude by comparing HT-IS in cuprates and in other classes of materials, especially Fe-based superconductors, and by examining the grand challenges currently laying ahead for the field.« less

  12. High temperature interface superconductivity

    SciTech Connect

    Gozar, A.; Bozovic, I.

    2016-01-20

    High-Tc superconductivity at interfaces has a history of more than a couple of decades. In this review we focus our attention on copper-oxide based heterostructures and multi-layers. We first discuss the technique, atomic layer-by-layer molecular beam epitaxy (ALL-MBE) engineering, that enabled High-Tc Interface Superconductivity (HT-IS), and the challenges associated with the realization of high quality interfaces. Then we turn our attention to the experiments which shed light on the structure and properties of interfacial layers, allowing comparison to those of single-phase films and bulk crystals. Both ‘passive’ hetero-structures as well as surface-induced effects by external gating are discussed. Here, we conclude by comparing HT-IS in cuprates and in other classes of materials, especially Fe-based superconductors, and by examining the grand challenges currently laying ahead for the field.

  13. High oxygen affinity hemoglobins.

    PubMed

    Mangin, O

    2017-02-01

    High oxygen affinity hemoglobins are responsible for rare and heterogeneous autosomic dominant genetic diseases. They cause pure erythrocytosis, sometimes accountable for hyperviscosity and thrombosis, or hemolysis. Differential diagnoses must be first ruled out. The diagnosis is based on the identification of a decreased P50, and their possible characterization by cation exchange-high performance liquid chromatography and capillary electrophoresis. Finally, genetic studies of the responsible globin chain gene will confirm the mutation. The prognosis mainly relies on the P50 decrease rate and on the hemoglobin cooperativity impairment. Disease management should be personalized, and it should primarily depend on smoking cessation and physical activity. Phlebotomy and platelet aggregation inhibitors' prescriptions can be discussed. There is no contraindication to flights, high-altitude conditions, or pregnancy. Nevertheless, blood donation must be prohibited. Copyright © 2016 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

  14. High resolution data acquisition

    DOEpatents

    Thornton, G.W.; Fuller, K.R.

    1993-04-06

    A high resolution event interval timing system measures short time intervals such as occur in high energy physics or laser ranging. Timing is provided from a clock, pulse train, and analog circuitry for generating a triangular wave synchronously with the pulse train (as seen in diagram on patent). The triangular wave has an amplitude and slope functionally related to the time elapsed during each clock pulse in the train. A converter forms a first digital value of the amplitude and slope of the triangle wave at the start of the event interval and a second digital value of the amplitude and slope of the triangle wave at the end of the event interval. A counter counts the clock pulse train during the interval to form a gross event interval time. A computer then combines the gross event interval time and the first and second digital values to output a high resolution value for the event interval.

  15. High resolution data acquisition

    DOEpatents

    Thornton, Glenn W.; Fuller, Kenneth R.

    1993-01-01

    A high resolution event interval timing system measures short time intervals such as occur in high energy physics or laser ranging. Timing is provided from a clock (38) pulse train (37) and analog circuitry (44) for generating a triangular wave (46) synchronously with the pulse train (37). The triangular wave (46) has an amplitude and slope functionally related to the time elapsed during each clock pulse in the train. A converter (18, 32) forms a first digital value of the amplitude and slope of the triangle wave at the start of the event interval and a second digital value of the amplitude and slope of the triangle wave at the end of the event interval. A counter (26) counts the clock pulse train (37) during the interval to form a gross event interval time. A computer (52) then combines the gross event interval time and the first and second digital values to output a high resolution value for the event interval.

  16. High voltage power supply

    NASA Astrophysics Data System (ADS)

    Ruitberg, A. P.; Young, K. M.

    1985-05-01

    A high voltage power supply is formed by three discrete circuits energized by a battery to provide a plurality of concurrent output signals floating at a high output voltage on the order of several tens of kilovolts. In the first two circuits, the regulator stages are pulse width modulated and include adjustable ressistances for varying the duty cycles of pulse trains provided to corresponding oscillator stages while the third regulator stage includes an adjustable resistance for varying the amplitude of a steady signal provided to a third oscillator stage. In the first circuit, the oscillator, formed by a constant current drive network and a tuned resonant network included a step up transformer, is coupled to a second step up transformer which, in turn, supplies an amplified sinusoidal signal to a parallel pair of complementary poled rectifying, voltage multiplier stages to generate the high output voltage.

  17. Bioremediation of high explosives

    SciTech Connect

    Kitts, C.L.; Alvarez, M.A.; Hanners, J.L.; Ogden, K.L.; Vanderberg-Twary, L.; Unkefer, P.J.

    1995-09-01

    Manufacture and use of high explosives has resulted in contamination of ground water and soils throughout the world. The use of biological methods for remediation of high explosives contamination has received considerable attention in recent years. Biodegradation is most easily studied using organisms in liquid cultures. Thus, the amount of explosive that can be degraded in liquid culture is quite small. However, these experiments are useful for gathering basic information about the biochemical pathways of biodegradation, identifying appropriate organisms and obtaining rates of degradation. The authors` laboratory has investigated all three major areas of explosives bioremediation: explosives in solution, explosives in soil, and the disposal of bulk explosives from demilitarization operations. They investigated the three explosives most commonly used in modern high explosive formulations: 2,4,6-trinitrotoluene (TNT), hexahydro 1,3,5-trinitro-1,3,5-triazine (RDX) and octahydro-1,3,5,7-tetranitro-1,3,5,7-tetrazocine (HMX).

  18. High temperature interface superconductivity

    NASA Astrophysics Data System (ADS)

    Gozar, A.; Bozovic, I.

    2016-02-01

    High-Tc superconductivity at interfaces has a history of more than a couple of decades. In this review we focus our attention on copper-oxide based heterostructures and multi-layers. We first discuss the technique, atomic layer-by-layer molecular beam epitaxy (ALL-MBE) engineering, that enabled High-Tc Interface Superconductivity (HT-IS), and the challenges associated with the realization of high quality interfaces. Then we turn our attention to the experiments which shed light on the structure and properties of interfacial layers, allowing comparison to those of single-phase films and bulk crystals. Both 'passive' hetero-structures as well as surface-induced effects by external gating are discussed. We conclude by comparing HT-IS in cuprates and in other classes of materials, especially Fe-based superconductors, and by examining the grand challenges currently laying ahead for the field.

  19. High voltage power supply

    NASA Technical Reports Server (NTRS)

    Ruitberg, A. P.; Young, K. M. (Inventor)

    1985-01-01

    A high voltage power supply is formed by three discrete circuits energized by a battery to provide a plurality of concurrent output signals floating at a high output voltage on the order of several tens of kilovolts. In the first two circuits, the regulator stages are pulse width modulated and include adjustable ressistances for varying the duty cycles of pulse trains provided to corresponding oscillator stages while the third regulator stage includes an adjustable resistance for varying the amplitude of a steady signal provided to a third oscillator stage. In the first circuit, the oscillator, formed by a constant current drive network and a tuned resonant network included a step up transformer, is coupled to a second step up transformer which, in turn, supplies an amplified sinusoidal signal to a parallel pair of complementary poled rectifying, voltage multiplier stages to generate the high output voltage.

  20. High brightness electron accelerator

    DOEpatents

    Sheffield, Richard L.; Carlsten, Bruce E.; Young, Lloyd M.

    1994-01-01

    A compact high brightness linear accelerator is provided for use, e.g., in a free electron laser. The accelerator has a first plurality of acclerating cavities having end walls with four coupling slots for accelerating electrons to high velocities in the absence of quadrupole fields. A second plurality of cavities receives the high velocity electrons for further acceleration, where each of the second cavities has end walls with two coupling slots for acceleration in the absence of dipole fields. The accelerator also includes a first cavity with an extended length to provide for phase matching the electron beam along the accelerating cavities. A solenoid is provided about the photocathode that emits the electons, where the solenoid is configured to provide a substantially uniform magnetic field over the photocathode surface to minimize emittance of the electons as the electrons enter the first cavity.

  1. Highly Thermal Conductive Nanocomposites

    NASA Technical Reports Server (NTRS)

    Sun, Ya-Ping (Inventor); Connell, John W. (Inventor); Veca, Lucia Monica (Inventor)

    2015-01-01

    Disclosed are methods for forming carbon-based fillers as may be utilized in forming highly thermal conductive nanocomposite materials. Formation methods include treatment of an expanded graphite with an alcohol/water mixture followed by further exfoliation of the graphite to form extremely thin carbon nanosheets that are on the order of between about 2 and about 10 nanometers in thickness. Disclosed carbon nanosheets can be functionalized and/or can be incorporated in nanocomposites with extremely high thermal conductivities. Disclosed methods and materials can prove highly valuable in many technological applications including, for instance, in formation of heat management materials for protective clothing and as may be useful in space exploration or in others that require efficient yet light-weight and flexible thermal management solutions.

  2. High level nuclear waste

    SciTech Connect

    Crandall, J L

    1980-01-01

    The DOE Division of Waste Products through a lead office at Savannah River is developing a program to immobilize all US high-level nuclear waste for terminal disposal. DOE high-level wastes include those at the Hanford Plant, the Idaho Chemical Processing Plant, and the Savannah River Plant. Commercial high-level wastes, for which DOE is also developing immobilization technology, include those at the Nuclear Fuel Services Plant and any future commercial fuels reprocessing plants. The first immobilization plant is to be the Defense Waste Processing Facility at Savannah River, scheduled for 1983 project submission to Congress and 1989 operation. Waste forms are still being selected for this plant. Borosilicate glass is currently the reference form, but alternate candidates include concretes, calcines, other glasses, ceramics, and matrix forms.

  3. High Frequency EPR Spectroscopy

    NASA Astrophysics Data System (ADS)

    Gatteschi, D.

    EPR has traditionally been used in order to obtain structural information on transition metal compounds, with exciting frequencies in the range 9-35 GHz.The recent availability of high magnetic field has prompted the use of higher frequencies. In this contribution the advantages of using High-Field-High-Frequency EPR (HF EPR) experiments are reviewed. After a brief introduction aiming to recall the fundamentals of EPR spectroscopy, a short description of the experimental apparatus needed to perform HF EPR measurements is provided. The remaining sections report selected examples showing how much information can be obtained by HF EPR spectra. They range from individual ions with integer spin to molecular clusters. Particular attention is devoted to the so called Single Molecule Magnets, SMM, i.e. to molecular clusters which show slow relaxation of the magnetization at low temperature. This effect is due to Ising type magnetic anisotropy which has been efficiently monitored through HF EPR s pectroscopy.

  4. High resolution data acquisition

    SciTech Connect

    Thornton, G.W.; Fuller, K.R.

    1992-12-31

    A high resolution event interval timing system measures short time intervals such as occur in high energy physics or laser ranging. Timing is provided from a clock pulse train and analog circuitry for generating a triangular wave synchronously with the pulse train. The triangular wave has an amplitude and slope functionally related to the time elapsed during each clock pulse in the train. A converter forms a first digital value of the amplitude and slope of the triangle wave at the start of the event interval and a second digital value of the amplitude and slope of the triangle wave at the end of the event interval. A counter counts the clock pulse train during the interval to form a gross event interval time. A computer then combines the gross event interval time and the first and second digital values to output a high resolution value for the event interval.

  5. High brightness electron accelerator

    SciTech Connect

    Sheffield, R.L.; Carlsten, B.E.; Young, L.M.

    1992-12-31

    A compact high brightness linear accelerator is provided for use, e.g., in a free electron laser. The accelerator has a first plurality of acclerating cavities having end walls with four coupling slots for accelerating electrons to high velocities in the absence of quadrupole fields. A second plurality of cavities receives the high velocity electrons for further acceleration, where each of the second cavities has end walls with two coupling slots for acceleration in the absence of dipole fields. The accelerator also includes a first cavity with an extended length to provide for phase matching the electron beam along the accelerating cavities. A solenoid is provided about the photocathode that emits the electrons, where the solenoid is configured to provide a substantially uniform magnetic field over the photocathode surface to minimize emittance of the electrons as the electrons enter the first cavity.

  6. High-conflict divorce.

    PubMed

    Johnston, J R

    1994-01-01

    This article reviews available research studies of high-conflict divorce and its effects on children. Interparental conflict after divorce (defined as verbal and physical aggression, overt hostility, and distrust) and the primary parent's emotional distress are jointly predictive of more problematic parent-child relationships and greater child emotional and behavioral maladjustment. As a group, children of high-conflict divorce as defined above, especially boys, are two to four times more likely to be clinically disturbed in emotions and behavior compared with national norms. Court-ordered joint physical custody and frequent visitation arrangements in high-conflict divorce tend to be associated with poorer child outcomes, especially for girls. Types of intervention programs and social policy appropriate for these kinds of families are presented.

  7. HIGH POWER PULSED OSCILLATOR

    DOEpatents

    Singer, S.; Neher, L.K.

    1957-09-24

    A high powered, radio frequency pulse oscillator is described for generating trains of oscillations at the instant an input direct voltage is impressed, or immediately upon application of a light pulse. In one embodiment, the pulse oscillator comprises a photo-multiplier tube with the cathode connected to the first dynode by means of a resistor, and adjacent dynodes are connected to each other through adjustable resistors. The ohmage of the resistors progressively increases from a very low value for resistors adjacent the cathode to a high value adjacent the plate, the last dynode. Oscillation occurs with this circuit when a high negative voltage pulse is applied to the cathode and the photo cathode is bombarded. Another embodiment adds capacitors at the resistor connection points of the above circuit to increase the duration of the oscillator train.

  8. High temperature electronics

    NASA Astrophysics Data System (ADS)

    Seng, Gary T.

    1991-03-01

    In recent years, the aerospace propulsion and space power communities have acknowledged a growing need for electronic devices that are capable of sustained high-temperature operation. Aeropropulsion applications for high-temperature electronic devices include engine ground test instrumentation such as multiplexers, analog-to-digital converters, and telemetry systems capable of withstanding hot section engine temperatures in excess of 600 C. Uncooled operation of control and condition monitoring systems in advanced supersonic aircraft would subject the electronics to temperatures in excess of 300 C. Similarly, engine-mounted integrated electronic sensors could reach temperatures which exceed 500 C. In addition to aeronautics, there are many other areas that could benefit from the existence of high-temperature electronic devices. Space applications include power electronic devices for space platforms and satellites. Since power electronics require radiators to shed waste heat, electronic devices that operate at higher temperatures would allow a reduction in radiator size. Terrestrial applications include deep-well drilling instrumentation, high power electronics, and nuclear reactor instrumentation and control. To meet the needs of the applications mentioned previously, the high-temperature electronics (HTE) program at the Lewis Research Center is developing silicon carbide (SiC) as a high-temperature semiconductor material. Research is focused on developing the crystal growth, growth modeling, characterization, and device fabrication technologies necessary to produce a family of SiC devices. Interest in SiC has grown dramatically in recent years due to solid advances in the technology. Much research remains to be performed, but SiC appears ready to emerge as a useful semiconductor material.

  9. Highly-evolved stars

    NASA Technical Reports Server (NTRS)

    Heap, S. R.

    1981-01-01

    The ways in which the IUE has proved useful in studying highly evolved stars are reviewed. The importance of high dispersion spectra for abundance analyses of the sd0 stars and for studies of the wind from the central star of NGC 6543 and the wind from the 0 type component of Vela X-1 is shown. Low dispersion spectra are used for absolute spectrophotometry of the dwarf nova, Ex Hya. Angular resolution is important for detecting and locating UV sources in globular clusters.

  10. Fulminant high altitude blindness.

    PubMed

    Mashkovskiy, Evgeny; Szawarski, Piotr; Ryzhkov, Pavel; Goslar, Tomaz; Mrak, Irena

    2016-06-01

    Prolonged altitude exposure even with acclimatization continues to present a physiological challenge to all organ systems including the central nervous system. We describe a case of a 41-year-old Caucasian female climber who suffered severe visual loss that was due to possible optic nerve pathology occurring during a high altitude expedition in the Himalayas. This case is atypical of classic high altitude cerebral oedema and highlights yet another danger of prolonged sojourn at extreme altitudes. © International Society of Travel Medicine, 2016. All rights reserved. Published by Oxford University Press. For permissions, please e-mail: journals.permissions@oup.com.

  11. High Pressure Biomass Gasification

    SciTech Connect

    Agrawal, Pradeep K

    2016-07-29

    According to the Billion Ton Report, the U.S. has a large supply of biomass available that can supplement fossil fuels for producing chemicals and transportation fuels. Agricultural waste, forest residue, and energy crops offer potential benefits: renewable feedstock, zero to low CO2 emissions depending on the specific source, and domestic supply availability. Biomass can be converted into chemicals and fuels using one of several approaches: (i) biological platform converts corn into ethanol by using depolymerization of cellulose to form sugars followed by fermentation, (ii) low-temperature pyrolysis to obtain bio-oils which must be treated to reduce oxygen content via HDO hydrodeoxygenation), and (iii) high temperature pyrolysis to produce syngas (CO + H2). This last approach consists of producing syngas using the thermal platform which can be used to produce a variety of chemicals and fuels. The goal of this project was to develop an improved understanding of the gasification of biomass at high pressure conditions and how various gasification parameters might affect the gasification behavior. Since most downstream applications of synags conversion (e.g., alcohol synthesis, Fischer-Tropsch synthesis etc) involve utilizing high pressure catalytic processes, there is an interest in carrying out the biomass gasification at high pressure which can potentially reduce the gasifier size and subsequent downstream cleaning processes. It is traditionally accepted that high pressure should increase the gasification rates (kinetic effect). There is also precedence from coal gasification literature from the 1970s that high pressure gasification would be a beneficial route to consider. Traditional approach of using thermogravimetric analyzer (TGA) or high-pressure themogravimetric analyzer (PTGA) worked well in understanding the gasification kinetics of coal gasification which was useful in designing high pressure coal gasification processes. However

  12. High Energy Astrophysics Program

    NASA Technical Reports Server (NTRS)

    1996-01-01

    This report reviews activities performed by members of the USRA (Universities Space Research Association) contract team during the six months during the reporting period (10/95 - 3/96) and projected activities during the coming six months. Activities take place at the Goddard Space Flight Center, within the Laboratory for High Energy Astrophysics. Developments concern instrumentation, observation, data analysis, and theoretical work in Astrophysics. Missions supported include: Advanced Satellite for Cosmology and Astrophysics (ASCA), X-ray Timing Experiment (XTE), X-ray Spectrometer (XRS), Astro-E, High Energy Astrophysics Science, Archive Research Center (HEASARC), and others.

  13. High Performance FORTRAN

    NASA Technical Reports Server (NTRS)

    Mehrotra, Piyush

    1994-01-01

    High performance FORTRAN is a set of extensions for FORTRAN 90 designed to allow specification of data parallel algorithms. The programmer annotates the program with distribution directives to specify the desired layout of data. The underlying programming model provides a global name space and a single thread of control. Explicitly parallel constructs allow the expression of fairly controlled forms of parallelism in particular data parallelism. Thus the code is specified in a high level portable manner with no explicit tasking or communication statements. The goal is to allow architecture specific compilers to generate efficient code for a wide variety of architectures including SIMD, MIMD shared and distributed memory machines.

  14. High intensity hadron accelerators

    SciTech Connect

    Teng, L.C.

    1989-05-01

    This rapporteur report consists mainly of two parts. Part I is an abridged review of the status of all High Intensity Hadron Accelerator projects in the world in semi-tabulated form for quick reference and comparison. Part II is a brief discussion of the salient features of the different technologies involved. The discussion is based mainly on my personal experiences and opinions, tempered, I hope, by the discussions I participated in in the various parallel sessions of the workshop. In addition, appended at the end is my evaluation and expression of the merits of high intensity hadron accelerators as research facilities for nuclear and particle physics.

  15. High gradient electron guns

    SciTech Connect

    Fant, K.S.; Caryotakis, G.; Koontz, R.F.; Vlieks, A.E. ); Miram, G. , Atherton, CA )

    1990-08-01

    Experiments have been conducted to determine peak operating gradients attainable in thermionic electron guns. These tests are part of a study of high-current-density, long-life cathodes suitable for use in high power klystrons. We also investigated the use of chromium oxide coating as a means of inhibiting electronic breakdown across the focus electrode anode gap. Field gradients in excess of 280 kV/cm have been achieved for a gun operating at 240 kV with a beam current of 228 A, at pulse widths of the order of 1 {mu}s. 3 refs., 5 figs.

  16. High Availability Electronics Standards

    SciTech Connect

    Larsen, R.S.; /SLAC

    2006-12-13

    Availability modeling of the proposed International Linear Collider (ILC) predicts unacceptably low uptime with current electronics systems designs. High Availability (HA) analysis is being used as a guideline for all major machine systems including sources, utilities, cryogenics, magnets, power supplies, instrumentation and controls. R&D teams are seeking to achieve total machine high availability with nominal impact on system cost. The focus of this paper is the investigation of commercial standard HA architectures and packaging for Accelerator Controls and Instrumentation. Application of HA design principles to power systems and detector instrumentation are also discussed.

  17. High strength alloys

    DOEpatents

    Maziasz, Phillip James [Oak Ridge, TN; Shingledecker, John Paul [Knoxville, TN; Santella, Michael Leonard [Knoxville, TN; Schneibel, Joachim Hugo [Knoxville, TN; Sikka, Vinod Kumar [Oak Ridge, TN; Vinegar, Harold J [Bellaire, TX; John, Randy Carl [Houston, TX; Kim, Dong Sub [Sugar Land, TX

    2010-08-31

    High strength metal alloys are described herein. At least one composition of a metal alloy includes chromium, nickel, copper, manganese, silicon, niobium, tungsten and iron. System, methods, and heaters that include the high strength metal alloys are described herein. At least one heater system may include a canister at least partially made from material containing at least one of the metal alloys. At least one system for heating a subterranean formation may include a tubular that is at least partially made from a material containing at least one of the metal alloys.

  18. High strength alloys

    DOEpatents

    Maziasz, Phillip James; Shingledecker, John Paul; Santella, Michael Leonard; Schneibel, Joachim Hugo; Sikka, Vinod Kumar; Vinegar, Harold J.; John, Randy Carl; Kim, Dong Sub

    2012-06-05

    High strength metal alloys are described herein. At least one composition of a metal alloy includes chromium, nickel, copper, manganese, silicon, niobium, tungsten and iron. System, methods, and heaters that include the high strength metal alloys are described herein. At least one heater system may include a canister at least partially made from material containing at least one of the metal alloys. At least one system for heating a subterranean formation may include a tublar that is at least partially made from a material containing at least one of the metal alloys.

  19. High Energy Astrophysics Program

    NASA Technical Reports Server (NTRS)

    1996-01-01

    This report reviews activities performed-by members of the USRA contract team during the six months of the reporting period and projected activities during the coming six months. Activities take place at the Goddard Space Flight Center, visiting the Laboratory for High Energy Astrophysics. Developments concern instrumentation, observation, data analysis, and theoretical work in Astrophysics. Missions supported include: Advanced Satellite for Cosmology and Astrophysics (ASCA); X-ray Timing Experiment (XTE); X-ray Spectrometer (XRS); Astro-E; High Energy Astrophysics Science Archive Research Center (HEASARC), and others.

  20. High Current Power Controller

    DTIC Science & Technology

    1981-04-01

    AFWAL-TR-81- 2016 U iui.N HIGH CURRENT Ŕ POWER CONTROLLER P. E. McCOLLUM Audwo ROCKWELL INTERNATIONAL AUTONETICS STRATEGIC SYSTEMS DIVISION 3370...personnel. During norm3l operation, HCP \\.s pose no hazard, bLt unde- certain operating conditions potential noaza-ds do exist. They are: (1) During

  1. High School Projects.

    ERIC Educational Resources Information Center

    Learning By Design, 2002

    2002-01-01

    Describes the buildings of 30 high schools, including the educational context and design goals. Includes information on the architects and design team, a general building description, and general construction costs and specifications. Also provides a rough site plan and photographs. (EV)

  2. High Precision GPS Measurements

    DTIC Science & Technology

    2010-02-28

    GNSS Service (IGS) database, and magnetic field vectors from the International Geomagnetic Reference Field (IGRF) model [9]. These combined...Additonal correlations between the higher order range error and geomagnetic activity and seasonal variations are also obtained. Fig. 4 shows...clear correlation between the geomagnetic activity and enhanced higher order error at both sites. High Precision GPS Final Report Page 5 Fig.3

  3. Saving America's High Schools

    ERIC Educational Resources Information Center

    Smerdon, Becky, Ed.; Borman, Kathryn M., Ed.

    2009-01-01

    Our educational system is in a continuous state of reform, yet outcomes are nowhere near what we can accept. Though the search for answers is perpetual, many efforts over the past decade have homed in on one feature of high schools--their size. If we simply reduce school size, the argument goes, students will gain a safer environment that can…

  4. NOVA HIGH SCHOOL.

    ERIC Educational Resources Information Center

    Broward County Schools, Fort Lauderdale, FL.

    NOVA HIGH SCHOOL OPENED IN SEPTEMBER 1963 AS A UNIT OF THE SOUTH FLORIDA EDUCATIONAL CENTER. IT IS EXPERIMENTAL IN CONCEPT, BUT NOT IN CURRICULUM. ITS CONSTRUCTION, FEATURES, EQUIPMENT, TEACHING AIDS, AND INSTRUCTIONAL METHODS HAVE BEEN TESTED AND PROVED IN OTHER SCHOOL SYSTEMS. ITS PHILOSOPHY REPRESENTS A RETURN TO FUNDAMENTAL EDUCATION, BUT ITS…

  5. High Energy Exoplanet Transits

    NASA Astrophysics Data System (ADS)

    Llama, Joe; Shkolnik, Evgenya L.

    2017-10-01

    X-ray and ultraviolet transits of exoplanets allow us to probe the atmospheres of these worlds. High energy transits have been shown to be deeper but also more variable than in the optical. By simulating exoplanet transits using high-energy observations of the Sun, we can test the limits of our ability to accurately measure the properties of these planets in the presence of stellar activity. We use both disk-resolved images of the Solar disk spanning soft X-rays, the ultraviolet, and the optical and also disk-integrated Sun-as-a-star observations of the Lyα irradiance to simulate transits over a wide wavelength range. We find that for stars with activity levels similar to the Sun, the planet-to-star radius ratio can be overestimated by up to 50% if the planet occults an active region at high energies. We also compare our simulations to high energy transits of WASP-12b, HD 189733, 55 Cnc b, and GJ 436b.

  6. High School and beyond

    ERIC Educational Resources Information Center

    Gewertz, Catherine

    2009-01-01

    Educators and policymakers increasingly recognize that in middle school, a combination of strong academic preparation, close monitoring, and good support is pivotal to success in high school. But few middle schools have structured themselves so explicitly to deliver the double wallop of academic and counseling attention needed to get their…

  7. High Impact Instruction

    ERIC Educational Resources Information Center

    Knight, Jim

    2013-01-01

    The key to improving student achievement isn't more teacher time--it's more teacher impact. But how do you decide which instructional practices will deliver the most bang for your buck? In this handbook, written for teachers but suitable for use by principals and instructional coaches, best-selling author Jim Knight presents the high-leverage…

  8. High School Press Pressures.

    ERIC Educational Resources Information Center

    Rogers, Luella P.

    History shows that the high school press suffers through cycles that reflect economic factors and cultural climates within communities, states, and the nation. The direction of that cycle in the 1960s and early 1970s was toward more open, free-flowing information by a vigorous student press, but those economic and cultural signs now are pointing…

  9. High-Temperature Superconductivity

    ScienceCinema

    Peter Johnson

    2016-07-12

    Like astronomers tweaking images to gain a more detailed glimpse of distant stars, physicists at Brookhaven National Laboratory have found ways to sharpen images of the energy spectra in high-temperature superconductors — materials that carry electrical c

  10. High-Sensitivity Spectrophotometry.

    ERIC Educational Resources Information Center

    Harris, T. D.

    1982-01-01

    Selected high-sensitivity spectrophotometric methods are examined, and comparisons are made of their relative strengths and weaknesses and the circumstances for which each can best be applied. Methods include long path cells, noise reduction, laser intracavity absorption, thermocouple calorimetry, photoacoustic methods, and thermo-optical methods.…

  11. Energy at high altitude.

    PubMed

    Hill, N E; Stacey, M J; Woods, D R

    2011-03-01

    For the military doctor, an understanding of the metabolic effects of high altitude (HA) exposure is highly relevant. This review examines the acute metabolic challenge and subsequent changes in nutritional homeostasis that occur when troops deploy rapidly to HA. Key factors that impact on metabolism include the hypoxic-hypobaric environment, physical exercise and diet. Expected metabolic changes include augmentation of basal metabolic rate (BMR), decreased availability of oxygen in peripheral metabolic tissues, reduction in VO2 max, increased glucose dependency and lactate accumulation during exercise. The metabolic demands of exercise at HA are crucial. Equivalent activity requires greater effort and more energy than it does at sea level. Soldiers working at HA show high energy expenditure and this may exceed energy intake significantly. Energy intake at HA is affected adversely by reduced availability, reduced appetite and changes in endocrine parameters. Energy imbalance and loss of body water result in weight loss, which is extremely common at HA. Loss of fat predominates over loss of fat-free mass. This state resembles starvation and the preferential primary fuel source shifts from carbohydrate towards fat, reducing performance efficiency. However, these adverse effects can be mitigated by increasing energy intake in association with a high carbohydrate ration. Commanders must ensure that individuals are motivated, educated, strongly encouraged and empowered to meet their energy needs in order to maximise mission-effectiveness.

  12. CSTI high capacity power

    SciTech Connect

    Winter, J.M.

    1994-09-01

    The SP-100 program was established in 1983 by DOD, DOE, and NASA as a joint program to develop the technology necessary for space nuclear power systems for military and civil application. During FY86 and 87, the NASA SP-100 Advanced Technology Program was devised to maintain the momentum of promising technology advancement efforts started during Phase I of SP-100 and to strengthen, in key areas, the chances for successful development and growth capability of space nuclear reactor power systems for future space applications. In FY88, the Advanced Technology Program was incorporated into NASA`s new Civil Space Technology Initiative (CSTI). The CSTI Program was established to provide the foundation for technology development in automation and robotics, information, propulsion, and power. The CSTI High Capacity Power Program builds on the technology efforts of the SP-100 program, incorporates the previous NASA SP-100 Advanced Technology project, and provides a bridge to NASA Project Pathfinder. The elements of CSTI High Capacity Power development include Conversion Systems, Thermal Management, Power Management, System Diagnostics, and Environmental Interactions. Technology advancement in all areas, including materials, is required to assure the high reliability and 7 to 10 year lifetime demanded for future space nuclear power systems. The overall program will develop and demonstrate the technology base required to provide a wide range of modular power systems as well as allowing mission independence from solar and orbital attitude requirements. Several recent advancements in CSTI High Capacity power development will be discussed.

  13. High temperature superconducting compounds

    NASA Astrophysics Data System (ADS)

    Goldman, Allen M.

    1992-11-01

    The major accomplishment of this grant has been to develop techniques for the in situ preparation of high-Tc superconducting films involving the use of ozone-assisted molecular beam epitaxy. The techniques are generalizable to the growth of trilayer and multilayer structures. Films of both the DyBa2Cu3O(7-x) and YBa2Cu3O(7-x) compounds as well as the La(2-x)Sr(x)CuO4 compound have been grown on the usual substrates, SrTiO3, YSZ, MgO, and LaAlO3, as well as on Si substrates without any buffer layer. A bolometer has been fabricated on a thermally isolated SiN substrate coated with YSZ, an effort carried out in collaboration with Honeywell Inc. The deposition process facilitates the fabrication of very thin and transparent films creating new opportunities for the study of superconductor-insulator transitions and the investigation of photo-doping with carriers of high temperature superconductors. In addition to a thin film technology, a patterning technology has been developed. Trilayer structures have been developed for FET devices and tunneling junctions. Other work includes the measurement of the magnetic properties of bulk single crystal high temperature superconductors, and in collaboration with Argonne National Laboratory, measurement of electric transport properties of T1-based high-Tc films.

  14. Investing in High School

    ERIC Educational Resources Information Center

    Green, Daniel G.

    2012-01-01

    Strapped for cash, a Massachusetts high school creates its own venture capital fund to incentivize teachers to create programs that improve student learning. The result has been higher test scores and higher job satisfaction. One important program is credited with helping close the achievement gap at the school, while others have helped ambitious…

  15. High-School Village.

    ERIC Educational Resources Information Center

    Cotton, Bob

    2002-01-01

    Portrays the Sandra Day O'Connor High School in Helotes, Texas, whose architectural design, materials, and building forms reflect a rural Texas setting and a community wish that the large campus not overpower the nearby town. Includes photographs and a site plan. (GR)

  16. High-Sensitivity Spectrophotometry.

    ERIC Educational Resources Information Center

    Harris, T. D.

    1982-01-01

    Selected high-sensitivity spectrophotometric methods are examined, and comparisons are made of their relative strengths and weaknesses and the circumstances for which each can best be applied. Methods include long path cells, noise reduction, laser intracavity absorption, thermocouple calorimetry, photoacoustic methods, and thermo-optical methods.…

  17. High Temperature Piezoelectric Drill

    NASA Technical Reports Server (NTRS)

    Bao, Xiaoqi; Scott, James; Boudreau, Kate; Bar-Cohen, Yoseph; Sherrit, Stewart; Badescu, Mircea; Shrout, Tom; Zhang, Shujun

    2009-01-01

    The current NASA Decadal mission planning effort has identified Venus as a significant scientific target for a surface in-situ sampling/analyzing mission. The Venus environment represents several extremes including high temperature (460 deg C), high pressure (9 MPa), and potentially corrosive (condensed sulfuric acid droplets that adhere to surfaces during entry) environments. This technology challenge requires new rock sampling tools for these extreme conditions. Piezoelectric materials can potentially operate over a wide temperature range. Single crystals, like LiNbO3, have a Curie temperature that is higher than 1000 deg C and the piezoelectric ceramics Bismuth Titanate higher than 600 deg C. A study of the feasibility of producing piezoelectric drills that can operate in the temperature range up to 500 deg C was conducted. The study includes the high temperature properties investigations of engineering materials and piezoelectric ceramics with different formulas and doping. The drilling performances of a prototype Ultrasonic/Sonic Drill/Corer (USDC) using high temperate piezoelectric ceramics and single crystal were tested at temperature up to 500 deg C. The detailed results of our study and a discussion of the future work on performance improvements are presented in this paper.

  18. High View of Melas

    NASA Image and Video Library

    2006-03-13

    Soaring high above Valles Marineris, the Grand Canyon of Mars, viewers look down and catch a sight resembling parts of the desert West of the United States, but on a vastly greater scale. Here the canyon averages over a hundred miles wide.

  19. The Runner's High.

    ERIC Educational Resources Information Center

    Sachs, Michael L.

    Research concerning the euphoric state known as "the runner's high" is reviewed in an attempt to determine psychological factors behind the experience. Possible factors include cerebral dominance, relaxation, environmental influences, time and/or distance of run, and absence of personal problems. A list of references and several descriptions of…

  20. High-Performance Happy

    ERIC Educational Resources Information Center

    O'Hanlon, Charlene

    2007-01-01

    Traditionally, the high-performance computing (HPC) systems used to conduct research at universities have amounted to silos of technology scattered across the campus and falling under the purview of the researchers themselves. This article reports that a growing number of universities are now taking over the management of those systems and…

  1. High energy colliders

    SciTech Connect

    Palmer, R.B.; Gallardo, J.C.

    1997-02-01

    The authors consider the high energy physics advantages, disadvantages and luminosity requirements of hadron (pp, p{anti p}), lepton (e{sup +}e{sup {minus}}, {mu}{sup +}{mu}{sup {minus}}) and photon-photon colliders. Technical problems in obtaining increased energy in each type of machine are presented. The machines relative size are also discussed.

  2. High luminosity particle colliders

    SciTech Connect

    Palmer, R.B.; Gallardo, J.C.

    1997-03-01

    The authors consider the high energy physics advantages, disadvantages and luminosity requirements of hadron (pp, p{anti p}), lepton (e{sup +}e{sup {minus}}, {mu}{sup +}{mu}{sup {minus}}) and photon-photon colliders. Technical problems in obtaining increased energy in each type of machine are presented. The machines relative size are also discussed.

  3. Japan's High Schools.

    ERIC Educational Resources Information Center

    Rohlen, Thomas P.

    The author, an anthropologist, spent 14 months (1974-75) in the industrial port city of Kobe (Japan) observing a cross section of urban high schools, including Japan's most elite private school and a night vocational school plagued by absenteeism and delinquency. He reports on the character of the institutions and of the experience via…

  4. CSTI High Capacity Power

    NASA Technical Reports Server (NTRS)

    Winter, Jerry M.

    1989-01-01

    The SP-100 program was established in 1983 by DOD, DOE, and NASA as a joint program to develop the technology necessary for space nuclear power systems for military and civil application. During FY-86 and 87, the NASA SP-100 Advanced Technology Program was devised to maintain the momentum of promising technology advancement efforts started during Phase 1 of SP-100 and to strengthen, in key areas, the chances for successful development and growth capability of space nuclear reactor power systems for future space applications. In FY-88, the Advanced Technology Program was incorporated into NASA's new Civil Space Technology Initiative (CSTI). The CSTI Program was established to provide the foundation for technology development in automation and robotics, information, propulsion, and power. The CSTI High Capacity Power Program builds on the technology efforts of the SP-100 program, incorporates the previous NASA SP-100 Advanced Technology project, and provides a bridge to NASA Project Pathfinder. The elements of CSTI High Capacity Power development include Conversion Systems, Thermal Management, Power Management, System Diagnostics, and Environmental Interactions. Technology advancement in all areas, including materials, is required to assure the high reliability and 7 to 10 year lifetime demanded for future space nuclear power systems. The overall program will develop and demonstrate the technology base required to provide a wide range of modular power systems as well as allowing mission independence from solar and orbital attitude requirements. Several recent advancements in CSTI High Capacity power development will be discussed.

  5. PRODUCING HIGH CORN YIELDS.

    ERIC Educational Resources Information Center

    Illinois Univ., Urbana. Coll. of Agriculture.

    RESOURCE MATERIAL ON CORN PRODUCTION FOR HIGH SCHOOL VOCATIONAL AGRICULTURE AND ADULT FARMER CLASSES WAS DESIGNED BY A STATE LEVEL GROUP OF SUBJECT MATTER SPECIALISTS, TEACHER EDUCATORS, SUPERVISORS, AND TEACHERS TO HELP SOLVE PROBLEMS THAT CONFRONT CORN PRODUCERS AT PLANTING TIME. THE SUBJECT MATTER CONCERNS PLANTING TIME, DEPTH, ROW WIDTH,…

  6. Linguistics and High Technology.

    ERIC Educational Resources Information Center

    Paillet, Jean-Pierre

    There are two main areas of activity hidden behind the catch-phrase "high technology": the domain of computers and communication, and biological engineering. Because both deal with patterns of organization and information, it would seem that linguistics could contribute to their advancement. The main concept in information systems is…

  7. Maintaining High Teacher Morale

    ERIC Educational Resources Information Center

    Protheroe, Nancy

    2006-01-01

    In public education's current environment of high-stakes testing and accountability, principals are constantly engaged in an effort to balance messages to their teachers to achieve ever-higher levels of student learning with appreciation for what they do. As a result, it is not surprising that staff morale is an issue in some schools. The…

  8. Thinking Big, Aiming High

    ERIC Educational Resources Information Center

    Berkeley, Viv

    2010-01-01

    What do teachers, providers and policymakers need to do in order to support disabled learners to "think big and aim high"? That was the question put to delegates at NIACE's annual disability conference. Some clear themes emerged, with delegates raising concerns about funding, teacher training, partnership-working and employment for disabled…

  9. High efficiency RCCI combustion

    NASA Astrophysics Data System (ADS)

    Splitter, Derek A.

    An experimental investigation of the pragmatic limits of Reactivity Controlled Compression Ignition (RCCI) engine efficiency was performed. The study utilized engine experiments combined with zero-dimensional modeling. Initially, simulations were used to suggest conditions of high engine efficiency with RCCI. Preliminary simulations suggested that high efficiency could be obtained by using a very dilute charge with a high compression ratio. Moreover, the preliminary simulations further suggested that with simultaneous 50% reductions in heat transfer and incomplete combustion, 60% gross thermal efficiency may be achievable with RCCI. Following the initial simulations, experiments to investigate the combustion process, fuel effects, and methods to reduce heat transfer and incomplete combustion reduction were conducted. The results demonstrated that the engine cycle and combustion process are linked, and if high efficiency is to be had, then the combustion event must be tailored to the initial cycle conditions. It was found that reductions to engine heat transfer are a key enabler to increasing engine efficiency. In addition, it was found that the piston oil jet gallery cooling in RCCI may be unnecessary, as it had a negative impact on efficiency. Without piston oil gallery cooling, it was found that RCCI was nearly adiabatic, achieving 95% of the theoretical maximum cycle efficiency (air standard Otto cycle efficiency).

  10. Reshaping High School English.

    ERIC Educational Resources Information Center

    Pirie, Bruce

    This book takes up the question of what shape high school English studies should take in the coming years. It describes an English program that blends philosophical depth with classroom practicality. Drawing examples from commonly taught texts such as "Macbeth,""To Kill a Mockingbird," and "Lord of the Flies," the…

  11. [Junior High School Program.

    ERIC Educational Resources Information Center

    Wisconsin Univ. - Stout, Menomonie. Center for Vocational, Technical and Adult Education.

    The document contains eight student directed and two teacher directed activity packages, and a proposed curriculum guide; all pertain to field objectives 1, 2, or 3 of the Wisconsin Guide to Local Curriculum Improvement in Industrial Education, K-12. Geared to the junior high level, the student packages are entitled: Repair of a Lamp Cord and…

  12. High flux heat exchanger

    NASA Astrophysics Data System (ADS)

    Flynn, Edward M.; Mackowski, Michael J.

    1993-01-01

    This interim report documents the results of the first two phases of a four-phase program to develop a high flux heat exchanger for cooling future high performance aircraft electronics. Phase 1 defines future needs for high flux heat removal in advanced military electronics systems. The results are sorted by broad application categories: (1) commercial digital systems, (2) military data processors, (3) power processors, and (4) radar and optical systems. For applications expected to be fielded in five to ten years, the outlook is for steady state flux levels of 30-50 W/sq cm for digital processors and several hundred W/sq cm for power control applications. In Phase 1, a trade study was conducted on emerging cooling technologies which could remove a steady state chip heat flux of 100 W/sq cm while holding chip junction temperature to 90 C. Constraints imposed on heat exchanger design, in order to reflect operation in a fighter aircraft environment, included a practical lower limit on coolant supply temperature, the preference for a nontoxic, nonflammable, and nonfreezing coolant, the need to minimize weight and volume, and operation in an accelerating environment. The trade study recommended the Compact High Intensity Cooler (CHIC) for design, fabrication, and test in the final two phases of this program.

  13. High-School Village.

    ERIC Educational Resources Information Center

    Cotton, Bob

    2002-01-01

    Portrays the Sandra Day O'Connor High School in Helotes, Texas, whose architectural design, materials, and building forms reflect a rural Texas setting and a community wish that the large campus not overpower the nearby town. Includes photographs and a site plan. (GR)

  14. Stony Pont High School.

    ERIC Educational Resources Information Center

    Design Cost Data, 2001

    2001-01-01

    Includes information about the building site, architectural design, master plan, materials, costs, scheduling, specifications, and square footage for the 86-acre Stony Point High School in Round Rock, Texas. Includes floor plan, general description, photos, and a list of manufacturers and suppliers used for the project. (GR)

  15. Naperville High School

    ERIC Educational Resources Information Center

    Robert Wood Johnson Foundation, 2012

    2012-01-01

    In a political climate where most public schools have reduced or eliminated P.E. entirely in response to budget cuts and increased pressure to improve academic test scores, Naperville High School in Illinois stands out as an anomaly. The school's already robust daily P.E. program is specifically designed around the notion that physical activity…

  16. Rocky Mountain High.

    ERIC Educational Resources Information Center

    Hill, David

    2001-01-01

    Describes Colorado's Eagle Rock School, which offers troubled teens a fresh start by transporting them to a tuition- free campus high in the mountains. The program encourages spiritual development as well as academic growth. The atmosphere is warm, loving, structured, and nonthreatening. The article profiles several students' experiences at the…

  17. A Superintendent's High Expectations

    ERIC Educational Resources Information Center

    Pascopella, Angela

    2009-01-01

    This article profiles Wanda Bamberg, superintendent of the Aldine (Texas) Independent School District. Bamberg is used to high expectations regardless of the circumstances. She is a firecracker of sorts who talks much and expects much from her staff members, teachers, and students, who are mostly at-risk, Black and Hispanic, and economically…

  18. High Nitrogen Stainless Steel

    DTIC Science & Technology

    2011-07-19

    Hydrogen Embrittlement in Steel by the Increment Loading Technique. Fractography: After the stress-life fatigue tests, the fracture surface morphology...study was conducted to clarify the mechanical properties and stress corrosion cracking (SCC) resistance of high nitrogen stainless steel (HNSS) plates...Corrosion Cracking 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18. NUMBER OF PAGES 19a. NAME OF RESPONSIBLE PERSON

  19. High energy particle astronomy.

    NASA Technical Reports Server (NTRS)

    Buffington, A.; Muller, R. A.; Smith, L. H.; Smoot, G. F.

    1972-01-01

    Discussion of techniques currently used in high energy particle astronomy for measuring charged and neutral cosmic rays and their isotope and momentum distribution. Derived from methods developed for accelerator experiments in particle physics, these techniques help perform important particle astronomy experiments pertaining to nuclear cosmic ray and gamma ray research, electron and position probes, and antimatter searches.

  20. High-Stakes Trouble.

    ERIC Educational Resources Information Center

    Howe, Harold II

    2000-01-01

    Critiquing Nina and Sol Horowitz's article advocating high-stakes tests, the author deplores deleterious effects of too-rigorous standards on poor students and recent immigrants. Without large-scale initiatives to affect their lives out of school, urban youngsters' prospects are dim. A National Research Council report offers testing guidelines.…

  1. High Performance Magnets

    DTIC Science & Technology

    2000-03-29

    Our efforts in this project were focused on three different materials, namely; interstitial Sm-Fe carbides and nitrides, high energy product Nd2Fe14B ...magnets with MgO addition, and nanocomposite Nd2Fe14B /alpha-Fe consisting of a fine mixture of hard and soft phases. In the Sm-Fe carbides and

  2. High resolution drift chambers

    SciTech Connect

    Va'vra, J.

    1985-07-01

    High precision drift chambers capable of achieving less than or equal to 50 ..mu..m resolutions are discussed. In particular, we compare so called cool and hot gases, various charge collection geometries, several timing techniques and we also discuss some systematic problems. We also present what we would consider an ''ultimate'' design of the vertex chamber. 50 refs., 36 figs., 6 tabs.

  3. High expression Zymomonas promoters

    DOEpatents

    Viitanen, Paul V.; Tao, Luan; Zhang, Yuying; Caimi, Perry G.; McCole, Laura : Zhang, Min; Chou, Yat-Chen; McCutchen, Carol M.; Franden, Mary Ann

    2011-08-02

    Identified are mutants of the promoter of the Z. mobilis glyceraldehyde-3-phosphate dehydrogenase gene, which direct improved expression levels of operably linked heterologous nucleic acids. These are high expression promoters useful for expression of chimeric genes in Zymomonas, Zymobacter, and other related bacteria.

  4. Japan's High Schools.

    ERIC Educational Resources Information Center

    Rohlen, Thomas P.

    The author, an anthropologist, spent 14 months (1974-75) in the industrial port city of Kobe (Japan) observing a cross section of urban high schools, including Japan's most elite private school and a night vocational school plagued by absenteeism and delinquency. He reports on the character of the institutions and of the experience via…

  5. Highly oxidized superconductors

    DOEpatents

    Morris, Donald E.

    1994-01-01

    Novel superconducting materials in the form of compounds, structures or phases are formed by performing otherwise known syntheses in a highly oxidizing atmosphere rather than that created by molecular oxygen at atmospheric pressure or below. This leads to the successful synthesis of novel superconducting compounds which are thermodynamically stable at the conditions under which they are formed.

  6. Highly oxidized superconductors

    DOEpatents

    Morris, D.E.

    1994-09-20

    Novel superconducting materials in the form of compounds, structures or phases are formed by performing otherwise known synthesis in a highly oxidizing atmosphere rather than that created by molecular oxygen at atmospheric pressure or below. This leads to the successful synthesis of novel superconducting compounds which are thermodynamically stable at the conditions under which they are formed. 16 figs.

  7. High energy particle astronomy.

    NASA Technical Reports Server (NTRS)

    Buffington, A.; Muller, R. A.; Smith, L. H.; Smoot, G. F.

    1972-01-01

    Discussion of techniques currently used in high energy particle astronomy for measuring charged and neutral cosmic rays and their isotope and momentum distribution. Derived from methods developed for accelerator experiments in particle physics, these techniques help perform important particle astronomy experiments pertaining to nuclear cosmic ray and gamma ray research, electron and position probes, and antimatter searches.

  8. Revisiting High School Visits

    ERIC Educational Resources Information Center

    Flagel, Andrew

    2012-01-01

    NACAC's anniversary is a great time to follow up on an article on high school visits, a topic of ongoing discussion in every admission and guidance office. The article highlights a variety of potential good outcomes that can be derived from collaborative interactions. Sadly, however, admission representatives are apt to be described by the…

  9. Recovery High Schools

    ERIC Educational Resources Information Center

    Vogel, Carl

    2009-01-01

    This article discusses recovery high schools which are designed specifically to serve students who have been through a professional substance abuse treatment program and are working to stay away from drugs and alcohol. The schools typically serve multiple districts and are funded from both the per-pupil state funds that follow a student and what…

  10. High Temperature Piezoelectric Drill

    NASA Technical Reports Server (NTRS)

    Bao, Xiaoqi; Scott, James; Boudreau, Kate; Bar-Cohen, Yoseph; Sherrit, Stewart; Badescu, Mircea; Shrout, Tom; Zhang, Shujun

    2009-01-01

    The current NASA Decadal mission planning effort has identified Venus as a significant scientific target for a surface in-situ sampling/analyzing mission. The Venus environment represents several extremes including high temperature (460 deg C), high pressure (9 MPa), and potentially corrosive (condensed sulfuric acid droplets that adhere to surfaces during entry) environments. This technology challenge requires new rock sampling tools for these extreme conditions. Piezoelectric materials can potentially operate over a wide temperature range. Single crystals, like LiNbO3, have a Curie temperature that is higher than 1000 deg C and the piezoelectric ceramics Bismuth Titanate higher than 600 deg C. A study of the feasibility of producing piezoelectric drills that can operate in the temperature range up to 500 deg C was conducted. The study includes the high temperature properties investigations of engineering materials and piezoelectric ceramics with different formulas and doping. The drilling performances of a prototype Ultrasonic/Sonic Drill/Corer (USDC) using high temperate piezoelectric ceramics and single crystal were tested at temperature up to 500 deg C. The detailed results of our study and a discussion of the future work on performance improvements are presented in this paper.

  11. High School Feminist Studies.

    ERIC Educational Resources Information Center

    Ahlum, Carol, Comp.; Fralley, Jacqueline, Comp.

    This book describes courses on women's studies for the high school curriculum in literature and language and in history and social studies. Based on the women's social movement, women's studies is an alternative curriculum with goals to raise student consciousness about sexist curricula and society, compensate for the omission of women from…

  12. High Flux Heat Exchanger

    DTIC Science & Technology

    1993-01-01

    called an enhancement surfkce) is bonded to the chip. In both cases, the electronics board is immersed in a dielectric coolant . Bare chip cooling...the stocking of a dielectric coolant , which add to complexity and maintenance costs. 4. High performance heat pipe heat spreaders have demonstrated

  13. High Power Cryogenic Targets

    SciTech Connect

    Gregory Smith

    2011-08-01

    The development of high power cryogenic targets for use in parity violating electron scattering has been a crucial ingredient in the success of those experiments. As we chase the precision frontier, the demands and requirements for these targets have grown accordingly. We discuss the state of the art, and describe recent developments and strategies in the design of the next generation of these targets.

  14. High-Performance Happy

    ERIC Educational Resources Information Center

    O'Hanlon, Charlene

    2007-01-01

    Traditionally, the high-performance computing (HPC) systems used to conduct research at universities have amounted to silos of technology scattered across the campus and falling under the purview of the researchers themselves. This article reports that a growing number of universities are now taking over the management of those systems and…

  15. High Brightness OLED Lighting

    SciTech Connect

    Spindler, Jeffrey; Kondakova, Marina; Boroson, Michael; Hamer, John

    2016-05-25

    In this work we describe the technology developments behind our current and future generations of high brightness OLED lighting panels. We have developed white and amber OLEDs with excellent performance based on the stacking approach. Current products achieve 40-60 lm/W, while future developments focus on achieving 80 lm/W or higher.

  16. High purity tungsten targets

    NASA Technical Reports Server (NTRS)

    1975-01-01

    High purity tungsten, which is used for targets in X-ray tubes was considered for space processing. The demand for X-ray tubes was calculated using the growth rates for dental and medical X-ray machines. It is concluded that the cost benefits are uncertain.

  17. Saving America's High Schools

    ERIC Educational Resources Information Center

    Smerdon, Becky, Ed.; Borman, Kathryn M., Ed.

    2009-01-01

    Our educational system is in a continuous state of reform, yet outcomes are nowhere near what we can accept. Though the search for answers is perpetual, many efforts over the past decade have homed in on one feature of high schools--their size. If we simply reduce school size, the argument goes, students will gain a safer environment that can…

  18. Inorganic High Energy Oxidisers,

    DTIC Science & Technology

    properties may contribute significantly to the energy of the whole system. A book entitled ’Inorganic High - Energy Oxidisers’ by E.W. Lawless and I.C. Smith is the subject of this Essay Review by W.E. Batty.

  19. High School Press Pressures.

    ERIC Educational Resources Information Center

    Rogers, Luella P.

    History shows that the high school press suffers through cycles that reflect economic factors and cultural climates within communities, states, and the nation. The direction of that cycle in the 1960s and early 1970s was toward more open, free-flowing information by a vigorous student press, but those economic and cultural signs now are pointing…

  20. High strength composites evaluation

    SciTech Connect

    Marten, S.M.

    1992-02-01

    A high-strength, thick-section, graphite/epoxy composite was identified. The purpose of this development effort was to evaluate candidate materials and provide LANL with engineering properties. Eight candidate materials (Samples 1000, 1100, 1200, 1300, 1400, 1500, 1600, and 1700) were chosen for evaluation. The Sample 1700 thermoplastic material was the strongest overall.

  1. High Power Proton Facilities

    NASA Astrophysics Data System (ADS)

    Nagaitsev, Sergei

    2015-04-01

    This presentation will provide an overview of the capabilities and challenges of high intensity proton accelerators, such as J-PARC, Fermilab MI, SNS, ISIS, PSI, ESS (in the future) and others. The presentation will focus on lessons learned, new concepts, beam loss mechanisms and methods to mitigate them.

  2. Junior High School Science.

    ERIC Educational Resources Information Center

    Brinson, Gail; And Others

    Science instruction is the topic of this guide developed for the junior high schools of Duval County, Jacksonville, Florida. The subjects covered are (1) Biology I, Advanced, for grades 9-12; (2) Earth/Physical Science, Advanced, for advanced 8th graders; (3) Earth/Physical Science, Advanced (Field Test), for advanced 8th graders; (4) Earth…

  3. Nongrading the High School.

    ERIC Educational Resources Information Center

    Jenkins, John M.

    1998-01-01

    Reviews the history of nongraded high schools, from Preston Search's pioneering efforts in Pueblo, Colorado, to early 1900s Dalton and Winnetka Plans and midcentury continuous-progress plans. Competency, not age, already determines participation in band, orchestra, choir, and athletics. Curricula should be based on the structure, methodology, and…

  4. High Impact Instruction

    ERIC Educational Resources Information Center

    Knight, Jim

    2013-01-01

    The key to improving student achievement isn't more teacher time--it's more teacher impact. But how do you decide which instructional practices will deliver the most bang for your buck? In this handbook, written for teachers but suitable for use by principals and instructional coaches, best-selling author Jim Knight presents the high-leverage…

  5. A Superintendent's High Expectations

    ERIC Educational Resources Information Center

    Pascopella, Angela

    2009-01-01

    This article profiles Wanda Bamberg, superintendent of the Aldine (Texas) Independent School District. Bamberg is used to high expectations regardless of the circumstances. She is a firecracker of sorts who talks much and expects much from her staff members, teachers, and students, who are mostly at-risk, Black and Hispanic, and economically…

  6. Maintaining High Expectations

    ERIC Educational Resources Information Center

    Williams, Roger; Williams, Sherry

    2014-01-01

    Author and husband, Roger Williams, is hearing and signs fluently, and author and wife, Sherry Williams, is deaf and uses both speech and signs, although she is most comfortable signing. As parents of six children--deaf and hearing--they are determined to encourage their children to do their best, and they always set their expectations high. They…

  7. [Senior High School Program.

    ERIC Educational Resources Information Center

    Wisconsin Univ. - Stout, Menomonie. Center for Vocational, Technical and Adult Education.

    This student directed document contains five activity packages, a proposed curriculum, and a set of transparency masters; all pertain to field objectives 1, 4, or 5 of the Wisconsin Guide to Local Curriculum Improvement in Industrial Education, K-12. Geared to the junior and senior high school level, the packages are entitled: Co-op Program…

  8. Nongrading the High School.

    ERIC Educational Resources Information Center

    Jenkins, John M.

    1998-01-01

    Reviews the history of nongraded high schools, from Preston Search's pioneering efforts in Pueblo, Colorado, to early 1900s Dalton and Winnetka Plans and midcentury continuous-progress plans. Competency, not age, already determines participation in band, orchestra, choir, and athletics. Curricula should be based on the structure, methodology, and…

  9. High performance parallel architectures

    SciTech Connect

    Anderson, R.E. )

    1989-09-01

    In this paper the author describes current high performance parallel computer architectures. A taxonomy is presented to show computer architecture from the user programmer's point-of-view. The effects of the taxonomy upon the programming model are described. Some current architectures are described with respect to the taxonomy. Finally, some predictions about future systems are presented. 5 refs., 1 fig.

  10. Carthage High School Baseball.

    ERIC Educational Resources Information Center

    Woodfin, Samantha, Ed.

    1995-01-01

    This is the third issue of the magazine to focus on baseball in Panola County (Texas). The issue salutes the Carthage High School baseball program during two periods of its history. The first period was the early 1940's under Coach E. B. Morrison, whose teams were State Finalists in 1941 and 1942. The second period covered is the era of Coach…

  11. High purity tungsten targets

    NASA Technical Reports Server (NTRS)

    1975-01-01

    High purity tungsten, which is used for targets in X-ray tubes was considered for space processing. The demand for X-ray tubes was calculated using the growth rates for dental and medical X-ray machines. It is concluded that the cost benefits are uncertain.

  12. High-resolution headlamp

    NASA Astrophysics Data System (ADS)

    Gut, Carsten; Cristea, Iulia; Neumann, Cornelius

    2016-04-01

    The following article shall describe how human vision by night can be influenced. At first, front lighting systems that are already available on the market will be described, followed by their analysis with respect to the positive effects on traffic safety. Furthermore, how traffic safety by night can be increased since the introduction of high resolution headlamps shall be discussed.

  13. High speed flywheel

    SciTech Connect

    McGrath, S.V.

    1990-01-01

    This invention relates generally to flywheels and relates more particularly to the construction of a high speed, low-mass flywheel. Flywheels with which this invention is to be compared include those constructed of circumferentially wound filaments or fibers held together by a matrix or bonding material. Flywheels of such construction are known to possess a relatively high hoop strength but a relatively low radial strength. Hoop-wound flywheels are, therefore, particularly susceptible to circumferential cracks, and the radial stress limitations of such a flywheel substantially limit its speed capabilities. It is an object of the present invention to provide a new and improved flywheel which experiences reduced radial stress at high operating speeds. Another object of the present invention is to provide flywheel whose construction allows for radial growth as flywheel speed increases while providing the necessary stiffness for transferring and maintaining kinetic energy within the flywheel. Still another object of the present invention is to provide a flywheel having concentrically-disposed component parts wherein rotation induced radial stresses at the interfaces of such component parts approach zero. Yet another object of the present invention is to provide a flywheel which is particularly well-suited for high speed applications. 5 figs.

  14. High surface area calcite

    NASA Astrophysics Data System (ADS)

    Schultz, L. N.; Andersson, M. P.; Dalby, K. N.; Müter, D.; Okhrimenko, D. V.; Fordsmand, H.; Stipp, S. L. S.

    2013-05-01

    Calcite (CaCO3) is important in many fields—in nature, because it is a component of aquifers, oil reservoirs and prospective CO2 storage sites, and in industry, where it is used in products as diverse as paper, toothpaste, paint, plastic and aspirin. It is difficult to obtain high purity calcite with a high surface area but such material is necessary for industrial applications and for fundamental calcite research. Commercial powder is nearly always contaminated with growth inhibitors such as sugars, citrate or pectin and most laboratory synthesis methods deliver large precipitates, often containing vaterite or aragonite. To address this problem, we (i) adapted the method of carbonating a Ca(OH)2 slurry with CO2 gas to develop the first simple, cheap, safe and reproducible procedure using common laboratory equipment, to obtain calcite that reproducibly had a surface area of 14-17 m2/g and (ii) conducted a thorough characterization of the product. Scanning electron microscopy (SEM) revealed nanometer scale, rhombohedral crystals. X-ray diffraction (XRD), X-ray photoelectron spectroscopy (XPS) and infrared spectroscopy (IR) confirmed highly crystalline, pure calcite that more closely resembles the dimensions of the biogenic calcite produced by algae in coccoliths than other methods for synthesizing calcite. We suggest that this calcite is useful when purity and high surface area are important.

  15. High speed door assembly

    DOEpatents

    Shapiro, Carolyn

    1993-01-01

    A high speed door assembly, comprising an actuator cylinder and piston rods, a pressure supply cylinder and fittings, an electrically detonated explosive bolt, a honeycomb structured door, a honeycomb structured decelerator, and a structural steel frame encasing the assembly to close over a 3 foot diameter opening within 50 milliseconds of actuation, to contain hazardous materials and vapors within a test fixture.

  16. High speed door assembly

    DOEpatents

    Shapiro, C.

    1993-04-27

    A high speed door assembly is described, comprising an actuator cylinder and piston rods, a pressure supply cylinder and fittings, an electrically detonated explosive bolt, a honeycomb structured door, a honeycomb structured decelerator, and a structural steel frame encasing the assembly to close over a 3 foot diameter opening within 50 milliseconds of actuation, to contain hazardous materials and vapors within a test fixture.

  17. High Energy Astronomy Observatory

    NASA Technical Reports Server (NTRS)

    1980-01-01

    An overview of the High Energy Astronomy Observatory 2 contributions to X-ray astronomy is presented along with a brief description of the satellite and onboard telescope. Observations relating to galaxies and galactic clusters, black holes, supernova remnants, quasars, and cosmology are discussed.

  18. Philadelphia High School Academies.

    ERIC Educational Resources Information Center

    Neubauer, Antonia

    1986-01-01

    Describes Phaladelphia's four semiautonomous high school academies designed to provide disadvantaged students with a carefully aligned academic and vocational program and, ultimately, with relevant, marketable job skills. Discusses administration, academics, integration of academic and vocational courses, career education and counseling, work…

  19. Extremely High Velocity Outflows

    NASA Astrophysics Data System (ADS)

    Choi, Minho; Evans, Neal J., II; Jaffe, Daniel T.

    1993-11-01

    Extremely high velocity (EHV) wings, with full widths of 72 to 140 km s-1, are seen on the CO J = 3 → 2 lines toward W3 IRS 5, GL 490, NGC 2071, W28 A2 (G05.89-0.39), GL 2591, S140, and Cepheus A. Observations of 12CO and 13CO J = 3 → 2 and J = 2 → 1 lines indicate that optical depth generally decreases with increasing velocity separation from the ambient cloud velocity. Maps of the extremely high velocity (|V-V0| ≳ 20 km s-1) and the high-velocity (5 ≲ |V-V0| ≲ 20 km s-1) CO emission components show that the morphology of the two components is similar in W3 IRS 5 and W28 A2 but may be different in GL 2591, S140, and Cepheus A. The results of our survey suggest that EHV wings are common around infrared sources of moderate to high luminosity [500 to (4 × 105) Lsun] in dense regions. Line ratios imply that the EHV gas is usually optically thin and warm. Characteristic velocities range from 20 to 40 km s-1, yielding timescales of 1600-4200 yr. Since most sources in this study are producing some ionizing photons, these short timescales suggest that neutral winds coexist with ionizing photons. We examined two possible sources for the extremely high velocity CO emission: a neutral stellar wind; and swept-up or entrained molecular gas. Neither can be ruled out. If the high-velocity (HV) gas is swept up by a momentum-conserving stellar wind traced by the extremely high velocity CO emission, most of the C in the winds from luminous objects cannot be in CO. If the EHV and HV forces are equal, the fraction of C in a form other than CO increases with source luminosity and with the production rate of ionizing photons. This trend is natural in the stellar wind hypothesis, but models of winds around such luminous objects are needed. We consider other possible chemical states for the carbon in the stellar wind.

  20. High Selectivity Oxygen Delignification

    SciTech Connect

    Arthur J. Ragauskas Lucian A. Lucia Hasan Jameel

    2005-09-30

    The overall objective of this program was to develop improved extended oxygen delignification (EOD) technologies for current U.S. pulp mill operations. This was accomplished by: (1) Identifying pulping conditions that optimize O and OO performance; (2) Identifying structural features of lignin that enhance reactivity towards EOD of high kappa pulps; (3) Identifying factors minimizing carbohydrate degradation and improve pulp strength of EOD high kappa pulps; (4) Developing a simple, reproducible method of quantifying yield gains from EOD; and (5) Developing process conditions that significantly reduce the capital requirements of EOD while optimizing the yield benefits. Key research outcomes included, demonstrating the use of a mini-O sequence such as (E+O)Dkf:0.05(E+O) or Dkf:0.05(E+O)(E+O) without interstage washing could capture approximately 60% of the delignification efficiency of a conventional O-stage without the major capital requirements associated with an O-stage for conventional SW kraft pulps. The rate of formation and loss of fiber charge during an O-stage stage can be employed to maximize net fiber charge. Optimal fiber charge development and delignification are two independent parameters and do not parallel each other. It is possible to utilize an O-stage to enhance overall cellulosic fiber charge of low and high kappa SW kraft pulps which is beneficial for physical strength properties. The application of NIR and multi-variant analysis was developed into a rapid and simple method of determining the yield of pulp from an oxygen delignification stage that has real-world mill applications. A focus point of this program was the demonstration that Kraft pulping conditions and oxygen delignification of high and low-kappa SW and HW pulps are intimately related. Improved physical pulp properties and yield can be delivered by controlling the H-factor and active alkali charge. Low AA softwood kraft pulp with a kappa number 30 has an average improvement of 2% in

  1. High population increase rates.

    PubMed

    1991-09-01

    In addition to its economic and ethnic difficulties, the USSR faces several pressing demographic problems, including high population increase rates in several of its constituent republics. It has now become clear that although the country's rigid centralized planning succeeded in covering the basic needs of people, it did not lead to welfare growth. Since the 1970s, the Soviet economy has remained sluggish, which as led to increase in the death and birth rates. Furthermore, the ideology that held that demography could be entirely controlled by the country's political and economic system is contradicted by current Soviet reality, which shows that religion and ethnicity also play a significant role in demographic dynamics. Currently, Soviet republics fall under 2 categories--areas with high or low natural population increase rates. Republics with low rates consist of Christian populations (Armenia, Moldavia, Georgia, Byelorussia, Russia, Lithuania, Estonia, Latvia, Ukraine), while republics with high rates are Muslim (Tadzhikistan, Uzbekistan, Turkmenistan, Kirgizia, Azerbaijan Kazakhstan). The later group has natural increase rates as high as 3.3%. Although the USSR as a whole is not considered a developing country, the later group of republics fit the description of the UNFPA's priority list. Another serious demographic issue facing the USSR is its extremely high rate of abortion. This is especially true in the republics of low birth rates, where up to 60% of all pregnancies are terminated by induced abortions. Up to 1/5 of the USSR's annual health care budget is spent on clinical abortions -- money which could be better spent on the production of contraceptives. Along with the recent political and economic changes, the USSR is now eager to deal with its demographic problems.

  2. Keratoconus with high hyperopia.

    PubMed

    Martin, Raul

    2009-05-01

    To report the case of a patient with high hyperopia and bilateral keratoconus. A high hyperopic patient was evaluated using Orbscan corneal topography and slitlamp biomicroscopy to confirm suspected keratoconus. A male patient (32 years old) with a long history (10 years) of daily hydrogel contact lens wear with severe hyperopia was examined (RE +8.25-5.00 x 070 degrees , visual acuity [VA] 0.7 and LE +8.00-3.00 x 100 degrees , VA 0.9). The patient's Orbscan topography was compatible with bilateral asymmetric keratoconus (asymmetry of central dioptric power, irregular astigmatism, high anterior (110 and 63 microm for RE and LE, respectively) and posterior (200 and 128 microm for RE and LE, respectively) corneal elevation values; and corneal thinnest point (450 and 471 microm for RE and LE, respectively, in the cone). Slitlamp biomicroscopic findings included Vogt striae in RE. High Dk rigid gas-permeable CLs with keratoconus design (Z-B4P, Menicon, Japan) were fitted in both eyes (in RE the back optic zone radius [BOZR] was 7.70 mm, the total diameter was 10.00 mm, and the power was +4.00D, which provides a VA of 1.0; the LE BOZR was 7.65 mm, the total diameter was 10.00 mm, and the power was +4.25D, which provides a VA of 1.0). Although rare, keratoconus may occur in cases of high hyperopia. Management of hyperopic keratoconus with rigid gas-permeable contact lens fitting may be similar to that applied with other cases of keratoconus.

  3. High Voltage Seismic Generator

    NASA Astrophysics Data System (ADS)

    Bogacz, Adrian; Pala, Damian; Knafel, Marcin

    2015-04-01

    This contribution describes the preliminary result of annual cooperation of three student research groups from AGH UST in Krakow, Poland. The aim of this cooperation was to develop and construct a high voltage seismic wave generator. Constructed device uses a high-energy electrical discharge to generate seismic wave in ground. This type of device can be applied in several different methods of seismic measurement, but because of its limited power it is mainly dedicated for engineering geophysics. The source operates on a basic physical principles. The energy is stored in capacitor bank, which is charged by two stage low to high voltage converter. Stored energy is then released in very short time through high voltage thyristor in spark gap. The whole appliance is powered from li-ion battery and controlled by ATmega microcontroller. It is possible to construct larger and more powerful device. In this contribution the structure of device with technical specifications is resented. As a part of the investigation the prototype was built and series of experiments conducted. System parameter was measured, on this basis specification of elements for the final device were chosen. First stage of the project was successful. It was possible to efficiently generate seismic waves with constructed device. Then the field test was conducted. Spark gap wasplaced in shallowborehole(0.5 m) filled with salt water. Geophones were placed on the ground in straight line. The comparison of signal registered with hammer source and sparker source was made. The results of the test measurements are presented and discussed. Analysis of the collected data shows that characteristic of generated seismic signal is very promising, thus confirms possibility of practical application of the new high voltage generator. The biggest advantage of presented device after signal characteristics is its size which is 0.5 x 0.25 x 0.2 m and weight approximately 7 kg. This features with small li-ion battery makes

  4. High voltage pulse generator

    DOEpatents

    Fasching, George E.

    1977-03-08

    An improved high-voltage pulse generator has been provided which is especially useful in ultrasonic testing of rock core samples. An N number of capacitors are charged in parallel to V volts and at the proper instance are coupled in series to produce a high-voltage pulse of N times V volts. Rapid switching of the capacitors from the paralleled charging configuration to the series discharging configuration is accomplished by using silicon-controlled rectifiers which are chain self-triggered following the initial triggering of a first one of the rectifiers connected between the first and second of the plurality of charging capacitors. A timing and triggering circuit is provided to properly synchronize triggering pulses to the first SCR at a time when the charging voltage is not being applied to the parallel-connected charging capacitors. Alternate circuits are provided for controlling the application of the charging voltage from a charging circuit to be applied to the parallel capacitors which provides a selection of at least two different intervals in which the charging voltage is turned "off" to allow the SCR's connecting the capacitors in series to turn "off" before recharging begins. The high-voltage pulse-generating circuit including the N capacitors and corresponding SCR's which connect the capacitors in series when triggered "on" further includes diodes and series-connected inductors between the parallel-connected charging capacitors which allow sufficiently fast charging of the capacitors for a high pulse repetition rate and yet allow considerable control of the decay time of the high-voltage pulses from the pulse-generating circuit.

  5. High Blood Pressure in Pregnancy

    MedlinePlus

    ... The Health Information Center High Blood Pressure in Pregnancy What Is High Blood Pressure? Blood pressure is ... Are the Effects of High Blood Pressure in Pregnancy? Although many pregnant women with high blood pressure ...

  6. Prevention of High Blood Pressure

    MedlinePlus

    ... page from the NHLBI on Twitter. Prevention of High Blood Pressure Healthy lifestyle habits, proper use of medicines, and ... prevent high blood pressure or its complications. Preventing High Blood Pressure Onset Healthy lifestyle habits can help prevent high ...

  7. Fosaprepitant dimeglumine for the management of chemotherapy-induced nausea and vomiting: patient selection and perspectives

    PubMed Central

    Candelario, Nellowe; Lu, Marvin Louis Roy

    2016-01-01

    Chemotherapy-induced nausea and vomiting (CINV) is a debilitating side effect of antineoplastic agents. Several treatment regimens are used to address this problem. Fosaprepitant is a neurokinin-1 receptor blocker used in the prevention and treatment of CINV, especially for moderately and severely emetogenic chemotherapy. It is highly effective in the treatment of delayed CINV. Data from previous studies show that fosaprepitant is noninferior to aprepitant in the management of CINV. Fosaprepitant is given as a single-dose intravenous infusion, thus offering better patient compliance. The dose-limiting side effect of fosaprepitant is an infusion-related reaction, ranging from pain at the infusion site to thrombophlebitis. This side effect has been reported with coadministration of anthracycline agents. PMID:27382332

  8. Neurokinin-1 receptor antagonists for chemotherapy-induced nausea and vomiting.

    PubMed

    Aziz, Fahad

    2012-07-01

    Chemotherapy can be a life-prolonging treatment for many cancer patients, but it is often associated with profound nausea and vomiting that is so distressing that patients may delay or decline treatment to avoid these side effects. The discovery of several NK1 receptor antagonists is a big revolution to dealt this problem. NK1 receptor antagonists prevent both acute and delayed chemotherapy-induced nausea and vomiting (CINV). These agents act centrally at NK-1 receptors in vomiting centers within the central nervous system to block their activation by substance P released as an unwanted consequence of chemotherapy. By controlling nausea and vomiting, these agents help improve patients' daily living and their ability to complete multiple cycles of chemotherapy. They are effective for both moderately and highly emetogenic chemotherapy regimens. Their use might be associated with increased infection rates; however, additional appraisal of specific data from RCTs is needed.

  9. Palonosetron for the prevention of chemotherapy-induced nausea and vomiting.

    PubMed

    Mori-Vogt, Sherry; Blazer, Marlo

    2013-08-01

    Chemotherapy-induced nausea and vomiting (CINV) remains both a feared side effect of cancer treatment and a focus of many supportive care initiatives/guidelines. The class of medications known as serotonin receptor antagonists (5-HT3RAs) are integral in the prevention of CINV from both moderately and highly emetogenic chemotherapy. Palonosetron (ALOXI(®)), a second-generation 5-HT3RA, has a higher affinity for the 5-HT3 receptor, has a longer half-life and has unique interactions with the 5-HT3 receptor compared with the current first-generation 5-HT3RA such as ondansetron, granisetron, dolasetron and tropisetron. This may allow palonosetron an advantage in control of CINV. This review article examines the available evidence, the pharmacokinetics and the safety and tolerability of palonosetron in the prevention of CINV.

  10. Patient-centered management of chemotherapy-induced nausea and vomiting.

    PubMed

    Grunberg, Steven

    2012-04-01

    Oncology providers frequently underestimate the incidence of chemotherapy-induced nausea and vomiting (CINV), and patients often are reluctant to report symptoms. Inadequate patient-provider communication is a significant barrier to optimal management of this debilitating toxicity. The author reviews relevant published data and methods to optimize the clinical care of patients receiving chemotherapy with moderate-to-high emetogenic potential. Patient reticence plus physician expectations that patients will report symptoms accurately lead to lapses in communication and suboptimal clinical care. Communication strategies should serve to encourage patients to share the responsibility for establishing goals of therapy and understanding the risks and benefits of their selected antiemetic regimen, thereby becoming active participants in their own cancer care.

  11. High Temperature Thermosets

    NASA Technical Reports Server (NTRS)

    Hergenrother, Paul M.

    1999-01-01

    A thermoset or network polymer is an organic material where the molecules are tied together through chemical bonds (crosslinks) and therefore they cannot move past one another. As a result, these materials exhibit a certain degree of dimensional stability. The chemical composition and the degree of crosslink density of the thermoset have a pronounced effect upon the properties. High temperature thermosets offer a favorable combination of properties that makes them attractive for many applications. Their most important features are the excellent processability particularly of the low molecular weight precusor forms, the chemical and solvent resistance and the dimensional stability. The market for high temperature thermosets will increase as new uses for them are uncovered and new thermosets with better combinations of properties are developed.

  12. [High frequency ultrasound].

    PubMed

    Sattler, E

    2015-07-01

    Diagnostic ultrasound has become a standard procedure in clinical dermatology. Devices with intermediate high frequencies of 7.5-15 MHz are used in dermato-oncology for the staging and postoperative care of skin tumor patients and in angiology for improved vessel diagnostics. In contrast, the high frequency ultrasound systems with 20-100 MHz probes offer a much higher resolution, yet with a lower penetration depth of about 1 cm. The main indications are the preoperative measurements of tumor thickness in malignant melanoma and other skin tumors and the assessment of inflammatory and soft tissue diseases, offering information on the course of these dermatoses and allowing therapy monitoring. This article gives an overview on technical principles, devices, mode of examination, influencing factors, interpretation of the images, indications but also limitations of this technique.

  13. High Latitude Polygons

    NASA Technical Reports Server (NTRS)

    2005-01-01

    26 September 2005 This Mars Global Surveyor (MGS) Mars Orbiter Camera (MOC) image shows polygonal patterned ground on a south high-latitude plain. The outlines of the polygons, like the craters and hills in this region, are somewhat enhanced by the presence of bright frost left over from the previous winter. On Earth, polygons at high latitudes would usually be attributed to the seasonal freezing and thawing cycles of ground ice. The origin of similar polygons on Mars is less certain, but might also be an indicator of ground ice.

    Location near: 75.3oS, 113.2oW Image width: width: 3 km (1.9 mi) Illumination from: upper left Season: Southern Spring

  14. High temperature future

    SciTech Connect

    Sheinkopf, K.

    1994-09-01

    During the past few years, there have been dramatic accomplishments and success of high temperature solar thermal systems and significant development of these systems. High temperature technologies, about 500 F and higher, such as dish engines, troughs, central receiver power towers and solar process heat systems, have been tested, demonstrated and used in an array of applications, including many cost-effective utility bulk power production and demand side supply projects in the United States. Large systems provide power and hot water to prisons, schools, nursing homes and other institutions. Joint ventures with industry, utility projects, laboratory design assistance and other activities are building a solid industry of US solar thermal systems ready for use today.

  15. High energy transients

    NASA Technical Reports Server (NTRS)

    Woosley, S. E.

    1984-01-01

    A meeting was convened on the campus of the University of California at Santa Cruz during the two-week interval July 11 through July 22, 1983. Roughly 100 participants were chosen so as to give broad representation to all aspects of high energy transients. Ten morning review sessions were held in which invited speakers discussed the current status of observations and theory of the above subjects. Afternoon workshops were also held, usually more than one per day, to informally review various technical aspects of transients, confront shortcomings in theoretical models, and to propose productive courses for future research. Special attention was also given to the instrumentation used to study high energy transient and the characteristics and goals of a dedicated space mission to study transients in the next decade were determined. A listing of articles written by various members of the workshop is included.

  16. Highly directional acoustic receivers

    NASA Astrophysics Data System (ADS)

    Cray, Benjamin A.; Evora, Victor M.; Nuttall, Albert H.

    2003-03-01

    The theoretical directivity of a single combined acoustic receiver, a device that can measure many quantities of an acoustic field at a collocated point, is presented here. The formulation is developed using a Taylor series expansion of acoustic pressure about the origin of a Cartesian coordinate system. For example, the quantities measured by a second-order combined receiver, denoted a dyadic sensor, are acoustic pressure, the three orthogonal components of acoustic particle velocity, and the nine spatial gradients of the velocity vector. The power series expansion, which can be of any order, is cast into an expression that defines the directivity of a single receiving element. It is shown that a single highly directional dyadic sensor can have a directivity index of up to 9.5 dB. However, there is a price to pay with highly directive sensors; these sensors can be significantly more sensitive to nonacoustic noise sources.

  17. High Speed Video Insertion

    NASA Astrophysics Data System (ADS)

    Janess, Don C.

    1984-11-01

    This paper describes a means of inserting alphanumeric characters and graphics into a high speed video signal and locking that signal to an IRIG B time code. A model V-91 IRIG processor, developed by Instrumentation Technology Systems under contract to Instrumentation Marketing Corporation has been designed to operate in conjunction with the NAC model FHS-200 High Speed Video Camera which operates at 200 fields per second. The system provides for synchronizing the vertical and horizontal drive signals such that the vertical sync precisely coincides with five millisecond transitions in the IRIG time code. Additionally, the unit allows for the insertion of an IRIG time message as well as other data and symbols.

  18. High lift wake investigation

    NASA Technical Reports Server (NTRS)

    Sullivan, J. P.; Schneider, S. P.; Hoffenberg, R.

    1996-01-01

    The behavior of wakes in adverse pressure gradients is critical to the performance of high-lift systems for transport aircraft. Wake deceleration is known to lead to sudden thickening and the onset of reversed flow; this 'wake bursting' phenomenon can occur while surface flows remain attached. Although known to be important for high-lift systems, few studies of such decelerated wakes exist. In this study, the wake of a flat plate has been subjected to an adverse pressure gradient in a two-dimensional diffuser, whose panels were forced to remain attached by use of slot blowing. Pitot probe surveys, L.D.V. measurements, and flow visualization have been used to investigate the physics of this decelerated wake, through the onset of reversed flow.

  19. High energy from space

    NASA Technical Reports Server (NTRS)

    Margon, Bruce; Canizares, Claude; Catura, Richard C.; Clark, George W.; Fichtel, Carl E.; Friedman, Herbert; Giacconi, Riccardo; Grindlay, Jonathan E.; Helfand, David J.; Holt, Stephen S.

    1991-01-01

    The following subject areas are covered: (1) important scientific problems for high energy astrophysics (stellar activity, the interstellar medium in galaxies, supernovae and endpoints of stellar evolution, nucleosynthesis, relativistic plasmas and matter under extreme conditions, nature of gamma-bursts, identification of black holes, active nuclei, accretion physics, large-scale structures, intracluster medium, nature of dark matter, and the X- and gamma-ray background); (2) the existing experimental programs (Advanced X-Ray Astrophysics Facility (AXAF), Gamma Ray Observatory (GRO), X-Ray Timing Explorer (XTE), High Energy Transient Experiment (HETE), U.S. participation in foreign missions, and attached Shuttle and Space Station Freedom payloads); (3) major missions for the 1990's; (4) a new program of moderate missions; (5) new opportunities for small missions; (6) technology development issues; and (7) policy issues.

  20. High temperature structural silicides

    SciTech Connect

    Petrovic, J.J.

    1997-03-01

    Structural silicides have important high temperature applications in oxidizing and aggressive environments. Most prominent are MoSi{sub 2}-based materials, which are borderline ceramic-intermetallic compounds. MoSi{sub 2} single crystals exhibit macroscopic compressive ductility at temperatures below room temperature in some orientations. Polycrystalline MoSi{sub 2} possesses elevated temperature creep behavior which is highly sensitive to grain size. MoSi{sub 2}-Si{sub 3}N{sub 4} composites show an important combination of oxidation resistance, creep resistance, and low temperature fracture toughness. Current potential applications of MoSi{sub 2}-based materials include furnace heating elements, molten metal lances, industrial gas burners, aerospace turbine engine components, diesel engine glow plugs, and materials for glass processing.

  1. High voltage isolation transformer

    NASA Technical Reports Server (NTRS)

    Clatterbuck, C. H.; Ruitberg, A. P. (Inventor)

    1985-01-01

    A high voltage isolation transformer is provided with primary and secondary coils separated by discrete electrostatic shields from the surfaces of insulating spools on which the coils are wound. The electrostatic shields are formed by coatings of a compound with a low electrical conductivity which completely encase the coils and adhere to the surfaces of the insulating spools adjacent to the coils. Coatings of the compound also line axial bores of the spools, thereby forming electrostatic shields separating the spools from legs of a ferromagnetic core extending through the bores. The transformer is able to isolate a high constant potential applied to one of its coils, without the occurrence of sparking or corona, by coupling the coatings, lining the axial bores to the ferromagnetic core and by coupling one terminal of each coil to the respective coating encasing the coil.

  2. High temperature materials characterization

    NASA Technical Reports Server (NTRS)

    Workman, Gary L.

    1990-01-01

    A lab facility for measuring elastic moduli up to 1700 C was constructed and delivered. It was shown that the ultrasonic method can be used to determine elastic constants of materials from room temperature to their melting points. The ease in coupling high frequency acoustic energy is still a difficult task. Even now, new coupling materials and higher power ultrasonic pulsers are being suggested. The surface was only scratched in terms of showing the full capabilities of either technique used, especially since there is such a large learning curve in developing proper methodologies to take measurements into the high temperature region. The laser acoustic system does not seem to have sufficient precision at this time to replace the normal buffer rod methodology.

  3. High Efficiency Cell Development

    NASA Technical Reports Server (NTRS)

    Carbajal, B. G.

    1979-01-01

    The specific activity was to improve the tandem junction Cell (TJC) as a high efficiency solar cell. The TJC development was to be consistent with module assembly and should contribute to the overall goals of the Low-Cost Solar Array Project. During 1978, TJC efficiency improved from approximately 11 percent to approximately 16 percent (AMI). Photogenerated current densities in excess of 42 mA/sq cm were observed at AMO. Open circuit voltages as high as 0.615 V were measured at AMO. Fill factor was only 0.68 - 0.75 due to a nonoptimum metal contact design. A device model was conceived in which the solar cell is modelled as a transitor. There are virtually no interconnect or packaging factor systems and the TJC is compatible with all conventional module fabrication systems. A modification of the TJC, the Front Surface Field (FSF) cell, was also explored.

  4. Panoramic High Resolution Spectroscopy

    NASA Astrophysics Data System (ADS)

    Freeman, K.; Bland-Hawthorn, J.

    2008-10-01

    Stellar populations in galaxies are vast repositories of fossil information. In recent years it has become possible to consider high resolution spectroscopic surveys of millions of stars. New high resolution multi-object spectrographs on 4-8m class telescopes (HERMES, WFMOS) will allow us for the first time to make large and detailed chemical abundance surveys of stars in the Galactic disk, bulge and halo, and apply the techniques of chemical tagging to recovering the fossil information left over from galaxy assembly. These instruments will have strong synergies with the GAIA astrometric satellite due to launch in 2011. The level of detail made possible by these future facilities will be necessary if we are to fully understand the physical processes involved in galaxy formation.

  5. High Temperature ESP Monitoring

    SciTech Connect

    Jack Booker; Brindesh Dhruva

    2011-06-20

    The objective of the High Temperature ESP Monitoring project was to develop a downhole monitoring system to be used in wells with bottom hole well temperatures up to 300°C for measuring motor temperature, formation pressure, and formation temperature. These measurements are used to monitor the health of the ESP motor, to track the downhole operating conditions, and to optimize the pump operation. A 220 ºC based High Temperature ESP Monitoring system was commercially released for sale with Schlumberger ESP motors April of 2011 and a 250 ºC system with will be commercially released at the end of Q2 2011. The measurement system is now fully qualified, except for the sensor, at 300 °C.

  6. High temperature probe

    DOEpatents

    Swan, Raymond A.

    1994-01-01

    A high temperature probe for sampling, for example, smokestack fumes, and is able to withstand temperatures of 3000.degree. F. The probe is constructed so as to prevent leakage via the seal by placing the seal inside the water jacket whereby the seal is not exposed to high temperature, which destroys the seal. The sample inlet of the probe is also provided with cooling fins about the area of the seal to provide additional cooling to prevent the seal from being destroyed. Also, a heated jacket is provided for maintaining the temperature of the gas being tested as it passes through the probe. The probe includes pressure sensing means for determining the flow velocity of an efficient being sampled. In addition, thermocouples are located in various places on the probe to monitor the temperature of the gas passing there through.

  7. High temperature measuring device

    DOEpatents

    Tokarz, Richard D.

    1983-01-01

    A temperature measuring device for very high design temperatures (to 2,000.degree. C.). The device comprises a homogenous base structure preferably in the form of a sphere or cylinder. The base structure contains a large number of individual walled cells. The base structure has a decreasing coefficient of elasticity within the temperature range being monitored. A predetermined quantity of inert gas is confined within each cell. The cells are dimensionally stable at the normal working temperature of the device. Increases in gaseous pressure within the cells will permanently deform the cell walls at temperatures within the high temperature range to be measured. Such deformation can be correlated to temperature by calibrating similarly constructed devices under known time and temperature conditions.

  8. Prospects at high energies

    SciTech Connect

    Quigg, C.

    1988-11-01

    I discuss some possibilities for neutrino experiments in the fixed-target environment of the SPS, Tevatron, and UNK, with their primary proton beams of 0.4, 0.9, and 3.0 TeV. The emphasis is on unfinished business: issues that have been recognized for some time, but not yet resolved. Then I turn to prospects for proton-proton colliders to explore the 1-TeV scale. I review the motivation for new physics in the neighborhood of 1 TeV and mention some discovery possibilities for high-energy, high-luminosity hadron colliders and the implications they would have for neutrino physics. I raise the possibility of the direct study of neutrino interactions in hadron colliders. I close with a report on the status of the SSC project. 38 refs., 17 figs.

  9. High energy beam lines

    NASA Astrophysics Data System (ADS)

    Marchetto, M.; Laxdal, R. E.

    2014-01-01

    The ISAC post accelerator comprises an RFQ, DTL and SC-linac. The high energy beam lines connect the linear accelerators as well as deliver the accelerated beams to two different experimental areas. The medium energy beam transport (MEBT) line connects the RFQ to the DTL. The high energy beam transport (HEBT) line connects the DTL to the ISAC-I experimental stations (DRAGON, TUDA-I, GPS). The DTL to superconducting beam (DSB) transport line connects the ISAC-I and ISAC-II linacs. The superconducting energy beam transport (SEBT) line connects the SC linac to the ISAC-II experimental station (TUDA-II, HERACLES, TIGRESS, EMMA and GPS). All these lines have the function of transporting and matching the beams to the downstream sections by manipulating the transverse and longitudinal phase space. They also contain diagnostic devices to measure the beam properties.

  10. High frequency reference electrode

    DOEpatents

    Kronberg, James W.

    1994-01-01

    A high frequency reference electrode for electrochemical experiments comprises a mercury-calomel or silver-silver chloride reference electrode with a layer of platinum around it and a layer of a chemically and electrically resistant material such as TEFLON around the platinum covering all but a small ring or "halo" at the tip of the reference electrode, adjacent to the active portion of the reference electrode. The voltage output of the platinum layer, which serves as a redox electrode, and that of the reference electrode are coupled by a capacitor or a set of capacitors and the coupled output transmitted to a standard laboratory potentiostat. The platinum may be applied by thermal decomposition to the surface of the reference electrode. The electrode provides superior high-frequency response over conventional electrodes.

  11. High frequency reference electrode

    DOEpatents

    Kronberg, J.W.

    1994-05-31

    A high frequency reference electrode for electrochemical experiments comprises a mercury-calomel or silver-silver chloride reference electrode with a layer of platinum around it and a layer of a chemically and electrically resistant material such as TEFLON around the platinum covering all but a small ring or halo' at the tip of the reference electrode, adjacent to the active portion of the reference electrode. The voltage output of the platinum layer, which serves as a redox electrode, and that of the reference electrode are coupled by a capacitor or a set of capacitors and the coupled output transmitted to a standard laboratory potentiostat. The platinum may be applied by thermal decomposition to the surface of the reference electrode. The electrode provides superior high-frequency response over conventional electrodes. 4 figs.

  12. High efficiency magnetic bearings

    NASA Technical Reports Server (NTRS)

    Studer, Philip A.; Jayaraman, Chaitanya P.; Anand, Davinder K.; Kirk, James A.

    1993-01-01

    Research activities concerning high efficiency permanent magnet plus electromagnet (PM/EM) pancake magnetic bearings at the University of Maryland are reported. A description of the construction and working of the magnetic bearing is provided. Next, parameters needed to describe the bearing are explained. Then, methods developed for the design and testing of magnetic bearings are summarized. Finally, a new magnetic bearing which allows active torque control in the off axes directions is discussed.

  13. High current ion source

    DOEpatents

    Brown, Ian G.; MacGill, Robert A.; Galvin, James E.

    1990-01-01

    An ion source utilizing a cathode and anode for producing an electric arc therebetween. The arc is sufficient to vaporize a portion of the cathode to form a plasma. The plasma leaves the generation region and expands through another regon. The density profile of the plasma may be flattened using a magnetic field formed within a vacuum chamber. Ions are extracted from the plasma to produce a high current broad on beam.

  14. Highly Concurrent Scalar Processing.

    DTIC Science & Technology

    1986-01-01

    rearrangement arise from data dependencies between instructions, hence it is critical that artificial - dependencies are eliminated whenever possible...An important class of artificial depen- *. dencies arise due to register reuse. In the following example, no parallelism can be • . exploited in the...specific procedure call site. The use of inteligent procedure expansion techniques is expected to be crucial to the achievement of high performance

  15. High Mobility Conjugated Polymers

    DTIC Science & Technology

    2007-10-20

    PTTP) were also investigated by density functional theory (DFT) with the goal of understanding the effect of intramolecular charge transfer on the...10 -210 A10 The electronic structures of PTHQx and PTTP calculated by the 01 , ’°- density functional theory showed LUMO levels of -2.73 and -3.42 0...the design of high mobility semiconductors for organic field-effect transistors (OFETs) and other organic electronic devices. Although the tricyclic

  16. High energy fuel compositions

    SciTech Connect

    Fisher, D.H.

    1983-07-19

    A high density liquid hydrocarbon fuel composition is disclosed, singularly suited for propelling turbojet limited volume missile systems designed for shipborne deployment. The contemplated fuels are basically composed of the saturated analogues of dimers of methyl cyclopentadiene and of dicyclopentadiene and optionally include the saturated analogues of the co-trimers of said dienes or the trimers of cyclopentadiene. The various dimers and trimers are combined in a relative relationship to provide optimal performing fuels for the indicated purpose.

  17. High Power Modulator.

    DTIC Science & Technology

    1986-08-01

    The bushing consists of three segments of alumina tubing with interspersed metal rings. All metallic surfaces ex- *posed to vacuum are stainless steel...high voltage transient only lasted for several hundred ns, no vacuum insulator breakdown was noted during the tests. 4.2 Acceptance tests at PSI The...ation at 1 pps. The oil insulated output pulse transformer has multiple secondary windings which can be used to provide heater power for a thermionic

  18. Probability in High Dimension

    DTIC Science & Technology

    2014-06-30

    theory of Banach spaces, geometric functional analysis , convex geometry. • Mixing times and other phenomena in high-dimensional Markov chains. At... analysis of the behavior of Markov chains. This idea does not make sense in continuous time , as a Markov process evolves continuously and not in individual...To illustrate Theorem 5.32, let us prove a classical result in stochastic analysis due to P. Lévy on the modulus of continuity of Brownian motion

  19. High Latitude Ionospheric Structures

    DTIC Science & Technology

    2006-06-01

    CADI are a mixture of ionograms and ‘fixed’ frequency. The fixed frequency is chosen so as to get continuous ionospheric echoes throughout the day...because of the very dynamic ionospheric behaviour at high latitudes. Ionograms (interleaved with the fixed frequency observations) are at less frequent...intervals, typically each minute. In general it is easier to identify structures on the fixed frequency recordings. Ionograms are mainly useful when

  20. High Temperature Structural Foam

    NASA Technical Reports Server (NTRS)

    Weiser, Erik S.; Baillif, Faye F.; Grimsley, Brian W.; Marchello, Joseph M.

    1997-01-01

    The Aerospace Industry is experiencing growing demand for high performance polymer foam. The X-33 program needs structural foam insulation capable of retaining its strength over a wide range of environmental conditions. The High Speed Research Program has a need for low density core splice and potting materials. This paper reviews the state of the art in foam materials and describes experimental work to fabricate low density, high shear strength foam which can withstand temperatures from -220 C to 220 C. Commercially available polymer foams exhibit a wide range of physical properties. Some with densities as low as 0.066 g/cc are capable of co-curing at temperatures as high as 182 C. Rohacell foams can be resin transfer molded at temperatures up to 180 C. They have moduli of elasticity of 0.19 MPa, tensile strengths of 3.7 Mpa and compressive strengths of 3.6 MPa. The Rohacell foams cannot withstand liquid hydrogen temperatures, however Imi-Tech markets Solimide (trademark) foams which withstand temperatures from -250 C to 200 C, but they do not have the required structural integrity. The research activity at NASA Langley Research Center focuses on using chemical blowing agents to produce polyimide thermoplastic foams capable of meeting the above performance requirements. The combination of blowing agents that decompose at the minimum melt viscosity temperature together with plasticizers to lower the viscosity has been used to produce foams by both extrusion and oven heating. The foams produced exhibit good environmental stability while maintaining structural properties.

  1. Insulators for high voltages

    SciTech Connect

    Looms, J.S.T.

    1987-01-01

    This book describes electrical insulators for high voltage applications. Topics considered include the insulating materials, the manufacture of wet process porcelain, the manufacture of tempered glass, the glass-fibre core, the polymeric housing, the common problem - terminating an insulator, mechanical constraints, the physics of pollution flashover, the physics of contamination, testing of insulators, conclusions from testing, remedies for flashover, insulators for special cases, interference and noise, and the insulator of the future.

  2. High-Resolution Autoradiography

    NASA Technical Reports Server (NTRS)

    Towe, George C; Gomberg, Henry J; Freemen, J W

    1955-01-01

    This investigation was made to adapt wet-process autoradiography to metallurgical samples to obtain high resolution of segregated radioactive elements in microstructures. Results are confined to development of the technique, which was perfected to a resolution of less than 10 microns. The radioactive samples included carbon-14 carburized iron and steel, nickel-63 electroplated samples, a powder product containing nickel-63, and tungsten-185 in N-155 alloy.

  3. High Resolution Spectral Analysis

    DTIC Science & Technology

    2006-10-25

    filter - bank (one input many outputs) is then selected with a bandpass characteristic over the frequency range of interest. It consists of a dynamical...tailored to, disturbance isolation of a targeting system (e.g., laser) using input from a distributed array of 4 CHAPTER 1. ABSTRACT sensors. High...outstanding paper award from the IEEE Control Systems Society in 2003, and a U.S. patent [41] which was based on this and subsequent work. We mention that

  4. High Power Switching Transistor

    NASA Technical Reports Server (NTRS)

    Hower, P. L.; Kao, Y. C.; Carnahan, D. C.

    1983-01-01

    Improved switching transistors handle 400-A peak currents and up to 1,200 V. Using large diameter silicon wafers with twice effective area as D60T, form basis for D7 family of power switching transistors. Package includes npn wafer, emitter preform, and base-contact insert. Applications are: 25to 50-kilowatt high-frequency dc/dc inverters, VSCF converters, and motor controllers for electrical vehicles.

  5. High density circuit technology

    NASA Technical Reports Server (NTRS)

    Wade, T. E.

    1979-01-01

    Polyimide dielectric materials were acquired for comparative and evaluative studies in double layer metal processes. Preliminary experiments were performed. Also, the literature indicates that sputtered aluminum films may be successfully patterned using the left-off technique provided the substrate temperature remains low and the argon pressure in the chamber is relatively high at the time of sputtering. Vendors associated with dry processing equipment are identified. A literature search relative to future trends in VLSI fabrication techniques is described.

  6. High power arcjet

    NASA Technical Reports Server (NTRS)

    Auweter-Kurtz, M.; Glocker, B.; Goelz, T. M.; Habiger, H.; Kurtz, H. L.; Schrade, H. O.; Wegmann, T.

    1990-01-01

    The activities on the development of the high power arc jet HIPARC, the thrust balance, and plasma diagnostic probes are discussed. Modifications of the HIPARC design and a synopsis of the materials used are given. Further experimental results with the TT30 thruster in the 50 kW range are presented. Some first calibration measurements of the thrust balance are also included. Progress concerning the development of plasma diagnostic devices is documented.

  7. High Solids Coating System

    DTIC Science & Technology

    1980-06-01

    ongoing review of the commercial products literature, Cargill 5770, a polyester polyol from Cargill Inc., 36 TABLE 11 Correlation of Properties and...formulations were also determined. The polyester polyol (Cargill 5770) is higher in acid number (10 vs. 0.03) than the polycaprolactone polyol (NIAX PCP-0300...by block nurmber) High solids, Polyisocyanates, Polyol ., Polyesteru polyols , Titanium dioxide, Formulation stability. 10. ABSTIt)¶N (ContlnUe an r.e

  8. High-temperature superconductivity

    SciTech Connect

    Burns, G.

    1992-01-01

    Review of conventional superconductors. Structures. Normal-state properties. Superconducting properties. Vortex behavior, J[sub c], and applications. Index. An introductory presentation of high-temperature superconductivity, with emphasis on the experimental approach. Intended as a supplementary text for undergraduate solid state physics courses, assumes some background in physics and applicable technologies. Chapters contain unsolved problems. Bibliography and chapter notes appear at end of text.

  9. Highly fluorinated polyurethanes

    NASA Technical Reports Server (NTRS)

    Stump, E. C., Jr.; Rochow, S. E. (Inventor)

    1972-01-01

    New polyurethanes containing a high degree of fluorine atoms are reported. The presence of the fluorine atoms in the polyurethane resins provides material having good thermal stability and chemical resistance. These polyurethanes are derived from a new hydroxy-terminated perfluoro polyether. The hydroxy terminated material is reacted with a diisocyanate to produce the polyurethanes. The polyurethanes can be used to form seals, coatings, potting material, hoses and the like.

  10. High voltage generator

    DOEpatents

    Schwemin, A. J.

    1959-03-17

    A generator for producing relatively large currents at high voltages is described. In general, the invention comprises a plurality of capacitors connected in series by a plurality of switches alternately disposed with the capacitors. The above-noted circuit is mounted for movement with respect to contact members and switch closure means so that a load device and power supply are connected across successive numbers of capacitors, while the other capacitors are successively charged with the same power supply.

  11. High efficiency gas burner

    DOEpatents

    Schuetz, Mark A.

    1983-01-01

    A burner assembly provides for 100% premixing of fuel and air by drawing the air into at least one high velocity stream of fuel without power assist. Specifically, the nozzle assembly for injecting the fuel into a throat comprises a plurality of nozzles in a generally circular array. Preferably, swirl is imparted to the air/fuel mixture by angling the nozzles. The diffuser comprises a conical primary diffuser followed by a cusp diffuser.

  12. HIGH VOLTAGE GENERATOR

    DOEpatents

    Schwemin, A.J.

    1959-03-17

    A generator is presented for producing relatively large currents at high voltages. In general, the invention comprises a plurality of capacitors connected in series by a plurality of switches alternately disposed with the capacitors. The circuit is mounted for movement with respect to contact members and switch closure means so that a load device and power supply are connected across successive numbers of capacitors, while the other capacitors are successively charged with the same power supply.

  13. Ultra high resolution tomography

    SciTech Connect

    Haddad, W.S.

    1994-11-15

    Recent work and results on ultra high resolution three dimensional imaging with soft x-rays will be presented. This work is aimed at determining microscopic three dimensional structure of biological and material specimens. Three dimensional reconstructed images of a microscopic test object will be presented; the reconstruction has a resolution on the order of 1000 A in all three dimensions. Preliminary work with biological samples will also be shown, and the experimental and numerical methods used will be discussed.

  14. High voltage pulse conditioning

    DOEpatents

    Springfield, Ray M.; Wheat, Jr., Robert M.

    1990-01-01

    Apparatus for conditioning high voltage pulses from particle accelerators in order to shorten the rise times of the pulses. Flashover switches in the cathode stalk of the transmission line hold off conduction for a determinable period of time, reflecting the early portion of the pulses. Diodes upstream of the switches divert energy into the magnetic and electrostatic storage of the capacitance and inductance inherent to the transmission line until the switches close.

  15. High performance sapphire windows

    NASA Technical Reports Server (NTRS)

    Bates, Stephen C.; Liou, Larry

    1993-01-01

    High-quality, wide-aperture optical access is usually required for the advanced laser diagnostics that can now make a wide variety of non-intrusive measurements of combustion processes. Specially processed and mounted sapphire windows are proposed to provide this optical access to extreme environment. Through surface treatments and proper thermal stress design, single crystal sapphire can be a mechanically equivalent replacement for high strength steel. A prototype sapphire window and mounting system have been developed in a successful NASA SBIR Phase 1 project. A large and reliable increase in sapphire design strength (as much as 10x) has been achieved, and the initial specifications necessary for these gains have been defined. Failure testing of small windows has conclusively demonstrated the increased sapphire strength, indicating that a nearly flawless surface polish is the primary cause of strengthening, while an unusual mounting arrangement also significantly contributes to a larger effective strength. Phase 2 work will complete specification and demonstration of these windows, and will fabricate a set for use at NASA. The enhanced capabilities of these high performance sapphire windows will lead to many diagnostic capabilities not previously possible, as well as new applications for sapphire.

  16. HIGH VOLTAGE ION SOURCE

    DOEpatents

    Luce, J.S.

    1960-04-19

    A device is described for providing a source of molecular ions having a large output current and with an accelerated energy of the order of 600 kv. Ions are produced in an ion source which is provided with a water-cooled source grid of metal to effect maximum recombination of atomic ions to molecular ions. A very high accelerating voltage is applied to withdraw and accelerate the molecular ions from the source, and means are provided for dumping the excess electrons at the lowest possible potentials. An accelerating grid is placed adjacent to the source grid and a slotted, grounded accelerating electrode is placed adjacent to the accelerating grid. A potential of about 35 kv is maintained between the source grid and accelerating grid, and a potential of about 600 kv is maintained between the accelerating grid and accelerating electrode. In order to keep at a minimum the large number of oscillating electrons which are created when such high voltages are employed in the vicinity of a strong magnetic field, a plurality of high voltage cascaded shields are employed with a conventional electron dumping system being employed between each shield so as to dump the electrons at the lowest possible potential rather than at 600 kv.

  17. High temperature interfacial superconductivity

    SciTech Connect

    Bozovic, Ivan; Logvenov, Gennady; Gozar, Adrian Mihai

    2012-06-19

    High-temperature superconductivity confined to nanometer-scale interfaces has been a long standing goal because of potential applications in electronic devices. The spontaneous formation of a superconducting interface in bilayers consisting of an insulator (La.sub.2CuO.sub.4) and a metal (La.sub.1-xSr.sub.xCuO.sub.4), neither of which is superconducting per se, is described. Depending upon the layering sequence of the bilayers, T.sub.c may be either .about.15 K or .about.30 K. This highly robust phenomenon is confined to within 2-3 nm around the interface. After exposing the bilayer to ozone, T.sub.c exceeds 50 K and this enhanced superconductivity is also shown to originate from a 1 to 2 unit cell thick interfacial layer. The results demonstrate that engineering artificial heterostructures provides a novel, unconventional way to fabricate stable, quasi two-dimensional high T.sub.c phases and to significantly enhance superconducting properties in other superconductors. The superconducting interface may be implemented, for example, in SIS tunnel junctions or a SuFET.

  18. High Voltage Insulation Technology

    NASA Astrophysics Data System (ADS)

    Scherb, V.; Rogalla, K.; Gollor, M.

    2008-09-01

    In preparation of new Electronic Power Conditioners (EPC's) for Travelling Wave Tub Amplifiers (TWTA's) on telecom satellites a study for the development of new high voltage insulation technology is performed. The initiative is mandatory to allow compact designs and to enable higher operating voltages. In a first task a market analysis was performed, comparing different materials with respect to their properties and processes. A hierarchy of selection criteria was established and finally five material candidates (4 Epoxy resins and 1 Polyurethane resin) were selected to be further investigated in the test program. Samples for the test program were designed to represent core elements of an EPC, the high voltage transformer and Printed Circuit Boards of the high voltage section. All five materials were assessed in the practical work flow of the potting process and electrical, mechanical, thermal and lifetime testing was performed. Although the lifetime tests results were overlayed by a larges scatter, finally two candidates have been identified for use in a subsequent qualification program. This activity forms part of element 5 of the ESA ARTES Programme.

  19. High Altitude Dermatology.

    PubMed

    Singh, Lt Col G K

    2017-01-01

    Approximately, 140 million people worldwide live permanently at high altitudes (HAs) and approximately another 40 million people travel to HA area (HAA) every year for reasons of occupation, sports or recreation. In India, whole of Ladakh region, part of Northwest Kashmir, Northern part of Sikkim and Tenga valley of Arunachal are considered inhabited areas of HAA. The low quantity of oxygen, high exposure of ultraviolet (UV) light, very low humidity, extreme subzero temperature in winter, high wind velocity, make this region difficult for lowlanders as well as for tourists. Acute mountain sickness, HA pulmonary edema, HA cerebral edema, and thromboembolic conditions are known to occur in HA. However, enough knowledge has not been shared on dermatoses peculiar to this region. Xerosis, UV-related skin disorders (tanning, photomelanosis, acute and chronic sunburn, polymorphic light eruption, chronic actinic dermatitis, actinic cheilitis, etc.), cold injuries (frostbite, chilblains, acrocyanosis, erythrocyanosis, etc.) nail changes (koilonychias), airborne contact dermatitis, insect bite reaction, and skin carcinoma (basal cell carcinomas, squamous cell carcinomas, and also rarely malignant melanoma) are the dermatoses seen in HAAs. Early diagnosis and knowledge of HA dermatoses may prevent serious consequences of disease and improve the quality of life for the visitors as well as for native of the place.

  20. High energy physics

    SciTech Connect

    Kernan, A.; Shen, B.C.; Ma, E.

    1997-07-01

    This proposal is for the continuation of the High Energy Physics program at the University of California at Riverside. In hadron collider physics the authors will complete their transition from experiment UA1 at CERN to the DZERO experiment at Fermilab. On experiment UA1 their effort will concentrate on data analysis at Riverside. At Fermilab they will coordinate the high voltage system for all detector elements. They will also carry out hardware/software development for the D0 muon detector. The TPC/Two-Gamma experiment has completed its present phase of data-taking after accumulating 160 pb{sup {minus}}1 of luminosity. The UC Riverside group will continue data and physics analysis and make minor hardware improvement for the high luminosity run. The UC Riverside group is participating in design and implementation of the data acquisition system for the OPAL experiment at LEP. Mechanical and electronics construction of the OPAL hadron calorimeter strip readout system is proceeding on schedule. Data analysis and Monte Carlo detector simulation efforts are proceeding in preparation for the first physics run when IEP operation comenses in fall 1989.

  1. High power beam analysis

    NASA Astrophysics Data System (ADS)

    Aharon, Oren

    2014-02-01

    In various modern scientific and industrial laser applications, beam-shaping optics manipulates the laser spot size and its intensity distribution. However the designed laser spot frequently deviates from the design goal due to real life imperfections and effects, such as: input laser distortions, optical distortion, heating, overall instabilities, and non-linear effects. Lasers provide the ability to accurately deliver large amounts of energy to a target area with very high accuracy. Thus monitoring beam size power and beam location is of high importance for high quality results and repeatability. Depending on the combination of wavelength, beam size and pulse duration , laser energy is absorbed by the material surface, yielding into processes such as cutting, welding, surface treatment, brazing and many other applications. This article will cover the aspect of laser beam measurements, especially at the focal point where it matters the most. A brief introduction to the material processing interactions will be covered, followed by fundamentals of laser beam propagation, novel measurement techniques, actual measurement and brief conclusions.

  2. High redshift blazars .

    NASA Astrophysics Data System (ADS)

    Ghisellini, G.

    Blazars are sources whose jet is pointing at us. Since their jets are relativistic, the flux is greatly amplified in the direction of motion, making blazars the most powerful persistent objects in the Universe. This is true at all frequencies, but especially where their spectrum peaks. Although the spectrum of moderate powerful sources peaks in the ˜GeV range, extremely powerful sources at high redshifts peak in the ˜MeV band. This implies that the hard X-ray band is the optimal one to find powerful blazars beyond a redshift of ˜4. First indications strongly suggest that powerful high-z blazars harbor the most massive and active early black holes, exceeding a billion solar masses. Since for each detected blazars there must exist hundreds of similar, but misaligned, sources, the search for high-z blazars is becoming competitive with the search of early massive black holes using radio-quiet quasars. Finding how the two populations of black holes (one in jetted sources, the other in radio-quiet objects) evolve in redshift will shed light on the growth of the most massive black holes and possibly on the feedback between the central engine and the rest of the host galaxy.

  3. High amplitude propagated contractions.

    PubMed

    Bharucha, A E

    2012-11-01

    While most colonic motor activity is segmental and non-propulsive, colonic high amplitude propagated contractions (HAPC) can transfer colonic contents over long distances and often precede defecation. High amplitude propagated contractions occur spontaneously, in response to pharmacological agents or colonic distention. A subset of patients with slow transit constipation have fewer HAPC. In this issue of Neurogastroenterology and Motility, Rodriguez et al. report that anal relaxation during spontaneous and bisacodyl-induced HAPC exceeds anal relaxation during rectal distention in constipated children undergoing colonic manometry. Moreover, and consistent with a neural mechanism, anal relaxation often precedes arrival of HAPC in the left colon. High amplitude propagated contractions are also used to evaluate the motor response to a meal and pharmacological stimuli (e.g., bisacodyl, neostigmine) and to identify colonic inertia during colonic motility testing in chronic constipation. This editorial comprehensively reviews the characteristics, physiology and pharmacology of HAPC, their assessment by manometry, and relevance to constipation and diarrhea. © 2012 Blackwell Publishing Ltd.

  4. High Altitude Dermatology

    PubMed Central

    Singh, Lt. Col. G K

    2017-01-01

    Approximately, 140 million people worldwide live permanently at high altitudes (HAs) and approximately another 40 million people travel to HA area (HAA) every year for reasons of occupation, sports or recreation. In India, whole of Ladakh region, part of Northwest Kashmir, Northern part of Sikkim and Tenga valley of Arunachal are considered inhabited areas of HAA. The low quantity of oxygen, high exposure of ultraviolet (UV) light, very low humidity, extreme subzero temperature in winter, high wind velocity, make this region difficult for lowlanders as well as for tourists. Acute mountain sickness, HA pulmonary edema, HA cerebral edema, and thromboembolic conditions are known to occur in HA. However, enough knowledge has not been shared on dermatoses peculiar to this region. Xerosis, UV-related skin disorders (tanning, photomelanosis, acute and chronic sunburn, polymorphic light eruption, chronic actinic dermatitis, actinic cheilitis, etc.), cold injuries (frostbite, chilblains, acrocyanosis, erythrocyanosis, etc.) nail changes (koilonychias), airborne contact dermatitis, insect bite reaction, and skin carcinoma (basal cell carcinomas, squamous cell carcinomas, and also rarely malignant melanoma) are the dermatoses seen in HAAs. Early diagnosis and knowledge of HA dermatoses may prevent serious consequences of disease and improve the quality of life for the visitors as well as for native of the place. PMID:28216727

  5. High Aspect Ratio Wrinkles

    NASA Astrophysics Data System (ADS)

    Chen, Yu-Cheng; Crosby, Alfred

    2015-03-01

    Buckling-induced surface undulations are widely found in living creatures, for instance, gut villi and the surface of flower petal cells. These undulations provide unique functionalities with their extremely high aspect ratios. For the synthetic systems, sinusoidal wrinkles that are induced by buckling a thin film attached on a soft substrate have been proposed to many applications. However, the impact of the synthetic wrinkles have been restricted by limited aspect ratios, ranging from 0 to 0.35. Within this range, wrinkle aspect ratio is known to increase with increasing compressive strain until a critical strain is reached, at which point wrinkles transition to localizations, such as folds or period doublings. Inspired by the living creatures, we propose that wrinkles can be stabilized in high aspect ratio by manipulating the strain energy in the substrate. We experimentally demonstrate this idea by forming a secondary crosslinking network in the wrinkled surface and successfully achieve aspect ratio as large as 0.8. This work not only provides insights for the mechanism of high aspect ratio structures seen in living creatures, but also demonstrates significant promise for future wrinkle-based applications.

  6. High Resolution Doppler Imager

    NASA Technical Reports Server (NTRS)

    Hays, Paul B.

    1999-01-01

    This report summarizes the accomplishments of the High Resolution Doppler Imager (HRDI) on UARS spacecraft during the period 4/l/96 - 3/31/99. During this period, HRDI operation, data processing, and data analysis continued, and there was a high level of vitality in the HRDI project. The HRDI has been collecting data from the stratosphere, mesosphere, and lower thermosphere since instrument activation on October 1, 1991. The HRDI team has stressed three areas since operations commenced: 1) operation of the instrument in a manner which maximizes the quality and versatility of the collected data; 2) algorithm development and validation to produce a high-quality data product; and 3) scientific studies, primarily of the dynamics of the middle atmosphere. There has been no significant degradation in the HRDI instrument since operations began nearly 8 years ago. HRDI operations are fairly routine, although we have continued to look for ways to improve the quality of the scientific product, either by improving existing modes, or by designing new ones. The HRDI instrument has been programmed to collect data for new scientific studies, such as measurements of fluorescence from plants, measuring cloud top heights, and lower atmosphere H2O.

  7. High pressure ceramic joint

    DOEpatents

    Ward, Michael E.; Harkins, Bruce D.

    1993-01-01

    Many recuperators have components which react to corrosive gases and are used in applications where the donor fluid includes highly corrosive gases. These recuperators have suffered reduced life, increased service or maintenance, and resulted in increased cost. The present joint when used with recuperators increases the use of ceramic components which do not react to highly corrosive gases. Thus, the present joint used with the present recuperator increases the life, reduces the service and maintenance, and reduces the increased cost associated with corrosive action of components used to manufacture recuperators. The present joint is comprised of a first ceramic member, a second ceramic member, a mechanical locking device having a groove defined in one of the first ceramic member and the second ceramic member. The joint and the mechanical locking device is further comprised of a refractory material disposed in the groove and contacting the first ceramic member and the second ceramic member. The present joint mechanically provides a high strength load bearing joint having good thermal cycling characteristics, good resistance to a corrosive environment and good steady state strength at elevated temperatures.

  8. High pressure ceramic joint

    DOEpatents

    Ward, M.E.; Harkins, B.D.

    1993-11-30

    Many recuperators have components which react to corrosive gases and are used in applications where the donor fluid includes highly corrosive gases. These recuperators have suffered reduced life, increased service or maintenance, and resulted in increased cost. The present joint when used with recuperators increases the use of ceramic components which do not react to highly corrosive gases. Thus, the present joint used with the present recuperator increases the life, reduces the service and maintenance, and reduces the increased cost associated with corrosive action of components used to manufacture recuperators. The present joint is comprised of a first ceramic member, a second ceramic member, a mechanical locking device having a groove defined in one of the first ceramic member and the second ceramic member. The joint and the mechanical locking device is further comprised of a refractory material disposed in the groove and contacting the first ceramic member and the second ceramic member. The present joint mechanically provides a high strength load bearing joint having good thermal cycling characteristics, good resistance to a corrosive environment and good steady state strength at elevated temperatures. 4 figures.

  9. High power coaxial ubitron

    NASA Astrophysics Data System (ADS)

    Balkcum, Adam J.

    In the ubitron, also known as the free electron laser, high power coherent radiation is generated from the interaction of an undulating electron beam with an electromagnetic signal and a static periodic magnetic wiggler field. These devices have experimentally produced high power spanning the microwave to x-ray regimes. Potential applications range from microwave radar to the study of solid state material properties. In this dissertation, the efficient production of high power microwaves (HPM) is investigated for a ubitron employing a coaxial circuit and wiggler. Designs for the particular applications of an advanced high gradient linear accelerator driver and a directed energy source are presented. The coaxial ubitron is inherently suited for the production of HPM. It utilizes an annular electron beam to drive the low loss, RF breakdown resistant TE01 mode of a large coaxial circuit. The device's large cross-sectional area greatly reduces RF wall heat loading and the current density loading at the cathode required to produce the moderate energy (500 keV) but high current (1-10 kA) annular electron beam. Focusing and wiggling of the beam is achieved using coaxial annular periodic permanent magnet (PPM) stacks without a solenoidal guide magnetic field. This wiggler configuration is compact, efficient and can propagate the multi-kiloampere electron beams required for many HPM applications. The coaxial PPM ubitron in a traveling wave amplifier, cavity oscillator and klystron configuration is investigated using linear theory and simulation codes. A condition for the dc electron beam stability in the coaxial wiggler is derived and verified using the 2-1/2 dimensional particle-in-cell code, MAGIC. New linear theories for the cavity start-oscillation current and gain in a klystron are derived. A self-consistent nonlinear theory for the ubitron-TWT and a new nonlinear theory for the ubitron oscillator are presented. These form the basis for simulation codes which, along

  10. High-frequency ECG

    NASA Technical Reports Server (NTRS)

    Tragardh, Elin; Schlegel, Todd T.

    2006-01-01

    The standard ECG is by convention limited to 0.05-150 Hz, but higher frequencies are also present in the ECG signal. With high-resolution technology, it is possible to record and analyze these higher frequencies. The highest amplitudes of the high-frequency components are found within the QRS complex. In past years, the term "high frequency", "high fidelity", and "wideband electrocardiography" have been used by several investigators to refer to the process of recording ECGs with an extended bandwidth of up to 1000 Hz. Several investigators have tried to analyze HF-QRS with the hope that additional features seen in the QRS complex would provide information enhancing the diagnostic value of the ECG. The development of computerized ECG-recording devices that made it possible to record ECG signals with high resolution in both time and amplitude, as well as better possibilities to store and process the signals digitally, offered new methods for analysis. Different techniques to extract the HF-QRS have been described. Several bandwidths and filter types have been applied for the extraction as well as different signal-averaging techniques for noise reduction. There is no standard method for acquiring and quantifying HF-QRS. The physiological mechanisms underlying HF-QRS are still not fully understood. One theory is that HF-QRS are related to the conduction velocity and the fragmentation of the depolarization wave in the myocardium. In a three-dimensional model of the ventricles with a fractal conduction system it was shown that high numbers of splitting branches are associated with HF-QRS. In this experiment, it was also shown that the changes seen in HF-QRS in patients with myocardial ischemia might be due to the slowing of the conduction velocity in the region of ischemia. This mechanism has been tested by Watanabe et al by infusing sodium channel blockers into the left anterior descending artery in dogs. In their study, 60 unipolar ECGs were recorded from the entire

  11. How to improve the prevention of chemotherapy-induced nausea and vomiting? The French NAVI study.

    PubMed

    Vanbockstael, Julie; Coquan, Elodie; Gouerant, Sophie; Allouache, Djelila; Faveyrial, Audrey; Noal, Sabine; Delcambre, Corinne; Galais, Marie-Pierre; Héron, Jean-François; Lefebvre, Anne-Charlotte; Sevin, Emmanuel; Hrab, Ioana; Polycarpe, Florence; André, Michel; Kaluzinski, Laure; Gervais, Radj; Gunzer, Katharina; Vié, Brigitte; Saucier, Gilles; Lemenand, Noëmie; Grellard, Jean-Michel; Clarisse, Bénédicte; Dugué, Audrey Emmanuelle; Joly, Florence

    2016-03-01

    Chemotherapy-induced nausea and vomiting (CINV) still remain frequent. The procedure for announcing the diagnosis (PAD) was an emblematic measure of the first French Plan Cancer aiming at providing patients with time to listen, information after cancer diagnosis, and discussion on treatments and their side effects. We aimed at assessing the risk factors of CINV, focusing on patients' satisfaction with the PAD. This prospective multicentre study assessed the frequency and intensity of CINV among chemonaïve patients during the first cycle of treatment. CINV was defined by ≥1 emetic episode or reported nausea intensity ≥3 on a 0-10 scale. Multivariate analysis was used to identify factors related to global CINV onset including satisfaction with the PAD (satisfaction score ≥the median on a 0-10 scale). Data from 291 patients (women, 85.2%; mean age, 57 years) were analyzed. Most patients (69.4%) received highly emetogenic chemotherapy regimens and 77.7% received antiemetic drugs consistent with international guidelines. Acute, delayed and overall CINV were experienced by 40.4, 34.8 and 52.4% of patients, respectively. Sixty-seven per cent of patients were satisfied with the PAD. No relation was noted between PAD satisfaction and CINV onset. The nausea and vomiting dimension of the QLQ-C30 questionnaire before chemotherapy (OR 3.62), motion sickness history (OR 2.73), highly emetogenic CT (OR 2.73), anxiety (OR 1.99) and younger age (OR 1.96) were independent predictive factors. Although patients were mostly satisfied with the PAD, half of them experienced CINV. A state of anxiety could be identified during the PAD to be managed.

  12. Antioxidant activity of ginger extract as a daily supplement in cancer patients receiving adjuvant chemotherapy: a pilot study

    PubMed Central

    Danwilai, Kwanjit; Konmun, Jitprapa; Sripanidkulchai, Bung-orn; Subongkot, Suphat

    2017-01-01

    Purpose The aim of this study was to examine the antioxidant activity of ginger extract oral supplement in newly diagnosed cancer patients receiving adjuvant chemotherapy compared to placebo. Patients and methods Newly diagnosed cancer patients receiving moderate-to-high emetogenic potential adjuvant chemotherapy were randomized to receive either a ginger extract (standardized 6-gingerol 20 mg/day) or a placebo 3 days prior to chemotherapy, which they continued daily. Oxidant/antioxidant parameters, including the activities of superoxide dismutase (SOD) and catalase (CAT) and levels of glutathione peroxidase (GPx), total glutathione (GSH/GSSG), lipid peroxidation products detected as malondialdehyde (MDA) and NO2−/NO3−, were measured at baseline and at days 1, 22, 43 and 64 after undergoing chemotherapy. Two-sided statistical analysis, with P < 0.05, was used to determine statistical significance. Results A total of 43 patients were included in the study: 19 and 24 patients were randomly assigned to the ginger group and placebo group, respectively. Antioxidant activity parameters, including SOD, CAT, GPx and GSH/GSSG, were significantly increased at day 64 in the ginger group compared to those in the placebo group, while MDA and NO2−/NO3− levels were significantly decreased (P < 0.0001). When compared to the baseline, the activities of SOD and CAT and the levels of GPx and GSH/GSSG were significantly higher on day 64 (P = 0.01), while the blood levels of MDA and NO2−/NO3− were significantly decreased (P < 0.01). Conclusion Daily supplement of ginger extract started 3 days prior to chemotherapy has been shown to significantly elevate antioxidant activity and reduce oxidative marker levels in patients who received moderate-to-high emetogenic potential chemotherapy compared to placebo. PMID:28203106

  13. Profile of netupitant/palonosetron (NEPA) fixed dose combination and its potential in the treatment of chemotherapy-induced nausea and vomiting (CINV)

    PubMed Central

    Navari, Rudolph M

    2015-01-01

    Chemotherapy-induced nausea and vomiting (CINV) is associated with a significant deterioration in quality of life. The emetogenicity of the chemotherapeutic agents, repeated chemotherapy cycles, and patient risk factors significantly influence CINV. The use of a combination of a 5-hydroxytryptamine-3 (5-HT3) receptor antagonists, dexamethasone, and a neurokinin-1 (NK-1) receptor antagonist has significantly improved the control of acute and delayed emesis in single-day chemotherapy. Palonosetron, a second generation 5-HT3 receptor antagonist with a different half-life, different binding capacity, and a different mechanism of action than the first generation 5-HT3 receptor antagonists, appears to be the most effective agent in its class. Netupitant, is a new NK-1 receptor antagonist with a high binding affinity, a long half-life of 90 hours, is metabolized by CYP3A4, and is an inhibitor of CYP3A4. NEPA is an oral fixed-dose combination of netupitant and palonosetron which has recently been employed in Phase II and Phase III clinical trials for the prevention of CINV in patients receiving moderately and highly emetogenic chemotherapy (MEC and HEC). The clinical trials demonstrated that NEPA (300 mg of netupitant plus 0.50 mg of palonosetron) significantly improved the prevention of CINV compared to the use of palonosetron alone in patients receiving either HEC or MEC. The clinical efficacy was maintained over multiple cycles of chemotherapy. NEPA (Akynzeo®) has recently been approved by the Food and Drug Administration (FDA) to treat nausea and vomiting in patients undergoing cancer chemotherapy. PMID:25552904

  14. Olanzapine for the Prevention of Chemotherapy-Induced Nausea and Vomiting.

    PubMed

    Navari, Rudolph M; Qin, Rui; Ruddy, Kathryn J; Liu, Heshan; Powell, Steven F; Bajaj, Madhuri; Dietrich, Leah; Biggs, David; Lafky, Jacqueline M; Loprinzi, Charles L

    2016-07-14

    We examined the efficacy of olanzapine for the prevention of nausea and vomiting in patients receiving highly emetogenic chemotherapy. In a randomized, double-blind, phase 3 trial, we compared olanzapine with placebo, in combination with dexamethasone, aprepitant or fosaprepitant, and a 5-hydroxytryptamine type 3-receptor antagonist, in patients with no previous chemotherapy who were receiving cisplatin (≥70 mg per square meter of body-surface area) or cyclophosphamide-doxorubicin. The doses of the three concomitant drugs administered before and after chemotherapy were similar in the two groups. The two groups received either 10 mg of olanzapine orally or matching placebo daily on days 1 through 4. Nausea prevention was the primary end point; a complete response (no emesis and no use of rescue medication) was a secondary end point. In the analysis, we included 380 patients who could be evaluated (192 assigned to olanzapine, and 188 to placebo). The proportion of patients with no chemotherapy-induced nausea was significantly greater with olanzapine than with placebo in the first 24 hours after chemotherapy (74% vs. 45%, P=0.002), the period from 25 to 120 hours after chemotherapy (42% vs. 25%, P=0.002), and the overall 120-hour period (37% vs. 22%, P=0.002). The complete-response rate was also significantly increased with olanzapine during the three periods: 86% versus 65% (P<0.001), 67% versus 52% (P=0.007), and 64% versus 41% (P<0.001), respectively. Although there were no grade 5 toxic effects, some patients receiving olanzapine had increased sedation (severe in 5%) on day 2. Olanzapine, as compared with placebo, significantly improved nausea prevention, as well as the complete-response rate, among previously untreated patients who were receiving highly emetogenic chemotherapy. (Funded by the National Cancer Institute; ClinicalTrials.gov number, NCT02116530.).

  15. Olanzapine for the Prevention of Chemotherapy-Induced Nausea and Vomiting

    PubMed Central

    Navari, Rudolph M.; Qin, Rui; Ruddy, Kathryn J.; Liu, Heshan; Powell, Steven F.; Bajaj, Madhuri; Dietrich, Leah; Biggs, David; Lafky, Jacqueline M.; Loprinzi, Charles L.

    2016-01-01

    BACKGROUND We examined the efficacy of olanzapine for the prevention of nausea and vomiting in patients receiving highly emetogenic chemotherapy. METHODS In a randomized, double-blind, phase 3 trial, we compared olanzapine with placebo, in combination with dexamethasone, aprepitant or fosaprepitant, and a 5-hydroxytryptamine type 3–receptor antagonist, in patients with no previous chemotherapy who were receiving cisplatin (≥70 mg per square meter of body-surface area) or cyclophosphamide–doxorubicin. The doses of the three concomitant drugs administered before and after chemotherapy were similar in the two groups. The two groups received either 10 mg of olanzapine orally or matching placebo daily on days 1 through 4. Nausea prevention was the primary end point; a complete response (no emesis and no use of rescue medication) was a secondary end point. RESULTS In the analysis, we included 380 patients who could be evaluated (192 assigned to olanzapine, and 188 to placebo). The proportion of patients with no chemotherapy-induced nausea was significantly greater with olanzapine than with placebo in the first 24 hours after chemotherapy (74% vs. 45%, P = 0.002), the period from 25 to 120 hours after chemotherapy (42% vs. 25%, P = 0.002), and the overall 120-hour period (37% vs. 22%, P = 0.002). The complete-response rate was also significantly increased with olanzapine during the three periods: 86% versus 65% (P<0.001), 67% versus 52% (P = 0.007), and 64% versus 41% (P<0.001), respectively. Although there were no grade 5 toxic effects, some patients receiving olanzapine had increased sedation (severe in 5%) on day 2. CONCLUSIONS Olanzapine, as compared with placebo, significantly improved nausea prevention, as well as the complete-response rate, among previously untreated patients who were receiving highly emetogenic chemotherapy. (Funded by the National Cancer Institute; ClinicalTrials.gov number, NCT02116530.) PMID:27410922

  16. Profile of netupitant/palonosetron (NEPA) fixed dose combination and its potential in the treatment of chemotherapy-induced nausea and vomiting (CINV).

    PubMed

    Navari, Rudolph M

    2015-01-01

    Chemotherapy-induced nausea and vomiting (CINV) is associated with a significant deterioration in quality of life. The emetogenicity of the chemotherapeutic agents, repeated chemotherapy cycles, and patient risk factors significantly influence CINV. The use of a combination of a 5-hydroxytryptamine-3 (5-HT3) receptor antagonists, dexamethasone, and a neurokinin-1 (NK-1) receptor antagonist has significantly improved the control of acute and delayed emesis in single-day chemotherapy. Palonosetron, a second generation 5-HT3 receptor antagonist with a different half-life, different binding capacity, and a different mechanism of action than the first generation 5-HT3 receptor antagonists, appears to be the most effective agent in its class. Netupitant, is a new NK-1 receptor antagonist with a high binding affinity, a long half-life of 90 hours, is metabolized by CYP3A4, and is an inhibitor of CYP3A4. NEPA is an oral fixed-dose combination of netupitant and palonosetron which has recently been employed in Phase II and Phase III clinical trials for the prevention of CINV in patients receiving moderately and highly emetogenic chemotherapy (MEC and HEC). The clinical trials demonstrated that NEPA (300 mg of netupitant plus 0.50 mg of palonosetron) significantly improved the prevention of CINV compared to the use of palonosetron alone in patients receiving either HEC or MEC. The clinical efficacy was maintained over multiple cycles of chemotherapy. NEPA (Akynzeo(®)) has recently been approved by the Food and Drug Administration (FDA) to treat nausea and vomiting in patients undergoing cancer chemotherapy.

  17. Randomized, placebo-controlled, pilot study evaluating aprepitant single dose plus palonosetron and dexamethasone for the prevention of acute and delayed chemotherapy-induced nausea and vomiting.

    PubMed

    Herrington, Jon D; Jaskiewicz, Adam D; Song, Juhee

    2008-05-01

    The combination of palonosetron and aprepitant is safe and effective in the prevention of chemotherapy-induced emesis (CIE). The purpose of this pilot study was to ascertain the effectiveness of 1-day versus 3-day aprepitant in the prevention of acute and delayed nausea and vomiting in patients who were receiving highly emetogenic chemotherapy. This study was institutional review board-approved and informed consent was obtained before this study was begun. This was a pilot, single-institution, randomized, double-blind, placebo-controlled trial that evaluated 3 different treatment arms. All groups received palonosetron 0.25 mg intravenously on Day 1 and dexamethasone on Days 1-4. Arm A received aprepitant 125 mg orally on Day 1 followed by 80 mg on Days 2-3. Arm B received aprepitant 125 mg orally on Day 1 and placebo on Days 2-3. Arm C received placebos on Days 1-3. The primary endpoint was to evaluate the proportion of patients with acute and delayed emesis within each group. Seventy-five patients were included in the analysis. The study commenced with 3 groups; however, an interim analysis displayed unacceptable emesis events in Arm C, and this group was terminated. There were no significant differences between Arms A and B for emesis, nausea, or the use of breakthrough antiemetics. In Arms A and B, 93% of patients were emesis-free from Days 1-5 compared with only 50% in Arm C. From this pilot study of patients who were receiving palonosetron, aprepitant, and dexamethasone for highly emetogenic chemotherapy, a single dose of aprepitant displayed similar effectiveness compared with 3-day aprepitant.

  18. HIGH EFFICIENCY SYNGAS GENERATION

    SciTech Connect

    Robert J. Copeland; Yevgenia Gershanovich; Brian Windecker

    2005-02-01

    This project investigated an efficient and low cost method of auto-thermally reforming natural gas to hydrogen and carbon monoxide. Reforming is the highest cost step in producing products such as methanol and Fisher Tropsch liquids (i.e., gas to liquids); and reducing the cost of reforming is the key to reducing the cost of these products. Steam reforming is expensive because of the high cost of the high nickel alloy reforming tubes (i.e., indirectly fired reforming tubes). Conventional auto-thermal or Partial Oxidation (POX) reforming minimizes the size and cost of the reformers and provides a near optimum mixture of CO and hydrogen. However POX requires pure oxygen, which consumes power and significantly increases the cost to reforming. Our high efficiency process extracts oxygen from low-pressure air with novel oxygen sorbent and transfers the oxygen to a nickel-catalyzed reformer. The syngas is generated at process pressure (typically 20 to 40 bar) without nitrogen dilution and has a 1CO to 2H{sub 2} ratio that is near optimum for the subsequent production of Fisher-Tropsch liquid to liquids and other chemicals (i.e., Gas to Liquids, GTL). Our high process efficiency comes from the way we transfer the oxygen into the reformer. All of the components of the process, except for the oxygen sorbent, are commonly used in commercial practice. A process based on a longlived, regenerable, oxygen transfer sorbent could substantially reduce the cost of natural gas reforming to syngas. Lower cost syngas (CO + 2H{sub 2}) that is the feedstock for GTL would reduce the cost of GTL and for other commercial applications (e.g., methanol, other organic chemicals). The vast gas resources of Alaska's North Slope (ANS) offer more than 22 Tcf of gas and GTL production in this application alone, and could account for as much as 300,000 to 700,000 bpd for 20 to 30+ years. We developed a new sorbent, which is an essential part of the High Efficiency Oxygen Process (HOP). We tested the

  19. High Speed Vortex Flows

    NASA Technical Reports Server (NTRS)

    Wood, Richard M.; Wilcox, Floyd J., Jr.; Bauer, Steven X. S.; Allen, Jerry M.

    2000-01-01

    A review of the research conducted at the National Aeronautics and Space Administration (NASA), Langley Research Center (LaRC) into high-speed vortex flows during the 1970s, 1980s, and 1990s is presented. The data reviewed is for flat plates, cavities, bodies, missiles, wings, and aircraft. These data are presented and discussed relative to the design of future vehicles. Also presented is a brief historical review of the extensive body of high-speed vortex flow research from the 1940s to the present in order to provide perspective of the NASA LaRC's high-speed research results. Data are presented which show the types of vortex structures which occur at supersonic speeds and the impact of these flow structures to vehicle performance and control is discussed. The data presented shows the presence of both small- and large scale vortex structures for a variety of vehicles, from missiles to transports. For cavities, the data show very complex multiple vortex structures exist at all combinations of cavity depth to length ratios and Mach number. The data for missiles show the existence of very strong interference effects between body and/or fin vortices and the downstream fins. It was shown that these vortex flow interference effects could be both positive and negative. Data are shown which highlights the effect that leading-edge sweep, leading-edge bluntness, wing thickness, location of maximum thickness, and camber has on the aerodynamics of and flow over delta wings. The observed flow fields for delta wings (i.e. separation bubble, classical vortex, vortex with shock, etc.) are discussed in the context of' aircraft design. And data have been shown that indicate that aerodynamic performance improvements are available by considering vortex flows as a primary design feature. Finally a discussing of a design approach for wings which utilize vortex flows for improved aerodynamic performance at supersonic speed is presented.

  20. [Detecting high risk pregnancy].

    PubMed

    Doret, Muriel; Gaucherand, Pascal

    2009-12-20

    Antenatal care is aiming to reduce maternal land foetal mortality and morbidity. Maternal and foetal mortality can be due to different causes. Their knowledge allows identifying pregnancy (high risk pregnancy) with factors associated with an increased risk for maternal and/or foetal mortality and serious morbidity. Identification of high risk pregnancies and initiation of appropriate treatment and/or surveillance should improve maternal and/or foetal outcome. New risk factors are continuously described thanks to improvement in antenatal care and development in biology and cytopathology, increasing complexity in identifying high risk pregnancies. Level of risk can change all over the pregnancy. Ideally, it should be evaluated prior to the pregnancy and at each antenatal visit. Clinical examination is able to screen for intra-uterin growth restriction, pre-eclampsia, threatened for preterm labour; ultrasounds help in the diagnosis of foetal morphological anomalies, foetal chromosomal anomalies, placenta praevia and abnormal foetal growth; biological exams are used to screen for pre-eclampsia, gestational diabetes, trisomy 21 (for which screening method just changed), rhesus immunisation, seroconversion for toxoplasmosis or rubeola, unknown infectious disease (syphilis, hepatitis B, VIH). During pregnancy, most of the preventive strategies have to be initiated during the first trimester or even before conception. Prevention for neural-tube defects, neonatal hypocalcemia and listeriosis should be performed for all women. On the opposite, some measures are concerning only women with risk factors such as prevention for toxoplasmosis, rhesus immunization (which recently changed), tobacco complications and pre-eclampsia and intra-uterine growth factor restriction.