Electric Propulsion Upper-Stage for Launch Vehicle Capability Enhancement

NASA Technical Reports Server (NTRS)

Kemp, Gregory E.; Dankanich, John W.; Woodcock, Gordon R.; Wingo, Dennis R.

2007-01-01

The NASA In-Space Propulsion Technology Project Office initiated a preliminary study to evaluate the performance benefits of a solar electric propulsion (SEP) upper-stage with existing and near-term small launch vehicles. The analysis included circular and elliptical Low Earth Orbit (LEO) to Geosynchronous Earth Orbit (GEO) transfers, and LEO to Low Lunar Orbit (LLO) applications. SEP subsystem options included state-of-the-art and near-term solar arrays and electric thrusters. In-depth evaluations of the Aerojet BPT-4000 Hall thruster and NEXT gridded ion engine were conducted to compare performance, cost and revenue potential. Preliminary results indicate that Hall thruster technology is favored for low-cost, low power SEP stages, while gridded-ion engines are favored for higher power SEP systems unfettered by transfer time constraints. A low-cost point design is presented that details one possible stage configuration and outlines system limitations, in particular fairing volume constraints. The results demonstrate mission enhancements to large and medium class launch vehicles, and mission enabling performance when SEP system upper stages are mounted to low-cost launchers such as the Minotaur and Falcon 1. Study results indicate the potential use of SEP upper stages to double GEO payload mass capability and to possibly enable launch on demand capability for GEO assets. Transition from government to commercial applications, with associated cost/benefit analysis, has also been assessed. The sensitivity of system performance to specific impulse, array power, thruster size, and component costs are also discussed.

Upper Stage Engine Composite Nozzle Extensions

NASA Technical Reports Server (NTRS)

Valentine, Peter G.; Allen, Lee R.; Gradl, Paul R.; Greene, Sandra E.; Sullivan, Brian J.; Weller, Leslie J.; Koenig, John R.; Cuneo, Jacques C.; Thompson, James; Brown, Aaron;

NASA Ares 1 Crew Launch Vehicle Upper Stage Configuration Selection Process

NASA Technical Reports Server (NTRS)

Cook, Jerry R.

2006-01-01

The Upper Stage Element of NASA s Ares I Crew Launch Vehicle (CLV) is a "clean-sheet" approach that is being designed and developed in-house, with Element management at MSFC. The USE concept is a self-supporting cylindrical structure, approximately 115 long and 216" in diameter. While the Reusable Solid Rocket Booster (RSRB) design has changed since the CLV inception, the Upper Stage Element design has remained essentially a clean-sheet approach. Although a clean-sheet upper stage design inherently carries more risk than a modified design, it does offer many advantages: a design for increased reliability; built-in extensibility to allow for commonality/growth without major redesign; and incorporation of state-of-the-art materials, hardware, and design, fabrication, and test techniques and processes to facilitate a potentially better, more reliable system.

Inertial Upper Stage (IUS) software analysis

NASA Technical Reports Server (NTRS)

Grayson, W. L.; Nickel, C. E.; Rose, P. L.; Singh, R. P.

1979-01-01

The Inertial Upper Stage (IUS) System, an extension of the Space Transportation System (STS) operating regime to include higher orbits, orbital plane changes, geosynchronous orbits, and interplanetary trajectories is presented. The IUS software design, the IUS software interfaces with other systems, and the cost effectiveness in software verification are described. Tasks of the IUS discussed include: (1) design analysis; (2) validation requirements analysis; (3) interface analysis; and (4) requirements analysis.

Crew Launch Vehicle (CLV) Upper Stage Configuration Selection Process

NASA Technical Reports Server (NTRS)

Davis, Daniel J.; Coook, Jerry R.

2006-01-01

The Crew Launch Vehicle (CLV), a key component of NASA's blueprint for the next generation of spacecraft to take humans back to the moon, is being designed and built by engineers at NASA s Marshall Space Flight Center (MSFC). The vehicle s design is based on the results of NASA's 2005 Exploration Systems Architecture Study (ESAS), which called for development of a crew-launch system to reduce the gap between Shuttle retirement and Crew Exploration Vehicle (CEV) Initial Operating Capability, identification of key technologies required to enable and significantly enhance these reference exploration systems, and a reprioritization of near- and far-term technology investments. The Upper Stage Element (USE) of the CLV is a clean-sheet approach that is being designed and developed in-house, with element management at MSFC. The USE concept is a self-supporting cylindrical structure, approximately 115' long and 216" in diameter, consisting of the following subsystems: Primary Structures (LOX Tank, LH2 Tank, Intertank, Thrust Structure, Spacecraft Payload Adaptor, Interstage, Forward and Aft Skirts), Secondary Structures (Systems Tunnel), Avionics and Software, Main Propulsion System, Reaction Control System, Thrust Vector Control, Auxiliary Power Unit, and Hydraulic Systems. The ESAS originally recommended a CEV to be launched atop a four-segment Space Shuttle Main Engine (SSME) CLV, utilizing an RS-25 engine-powered upper stage. However, Agency decisions to utilize fewer CLV development steps to lunar missions, reduce the overall risk for the lunar program, and provide a more balanced engine production rate requirement prompted engineers to switch to a five-segment design with a single Saturn-derived J-2X engine. This approach provides for single upper stage engine development for the CLV and an Earth Departure Stage, single Reusable Solid Rocket Booster (RSRB) development for the CLV and a Cargo Launch Vehicle, and single core SSME development. While the RSRB design has

Reusable Agena study. Volume 1: Executive summary. [space shuttle Agena upper stage tug concept

NASA Technical Reports Server (NTRS)

1974-01-01

The shuttle Agena upper stage interim tug concept is based on a building block approach. These building block concepts are extensions of existing ascent Agena configurations. Several current improvements, have been used in developing the shuttle/Agena upper stage concepts. High-density acid is used as the Agena upper stage oxidizer. The baffled injector is used in the main engine. The DF-224 is a fourth generation computer currently in development and will be flight proven in the near future. The Agena upper stage building block concept uses the current Agena as a baseline, adds an 8.5-inch (21.6 cm) extension to the fuel tank for optimum mixture ratio, uses monomethyl hydrazine as fuel, exchanges a 150:1 nozzle extension for the existing 45:1, exchanges an Autonetics DF-224 for the existing Honeywell computer, and adds a star sensor for guidance update. These modifications to the current Agena provide a 5-foot (1.52m) diameter shuttle/Agena upper stage that will fly all Vandenberg Air Force Base missions in the reusable mode without resorting to a kick motor. The delta V velocity of the Agena is increased by use of a strap-on propellant tank option. This option provides a shuttle/Agena upper stage with the capability to place almost 3900 pounds (1769 kg) into geosynchronous orbit (24 hour period) without the aid of kick motors.

Oblimersen Sodium and Combination Chemotherapy in Treating Patients With Newly Diagnosed Stage I, Stage II, Stage III, or Stage IV Diffuse Large B-Cell Lymphoma

ClinicalTrials.gov

2012-10-11

Contiguous Stage II Adult Diffuse Large Cell Lymphoma; Noncontiguous Stage II Adult Diffuse Large Cell Lymphoma; Stage I Adult Diffuse Large Cell Lymphoma; Stage III Adult Diffuse Large Cell Lymphoma; Stage IV Adult Diffuse Large Cell Lymphoma

SLS Block 1-B and Exploration Upper Stage Navigation System Design

NASA Technical Reports Server (NTRS)

Oliver, T. Emerson; Park, Thomas B.; Smith, Austin; Anzalone, Evan; Bernard, Bill; Strickland, Dennis; Geohagan, Kevin; Green, Melissa; Leggett, Jarred

2018-01-01

The SLS Block 1B vehicle is planned to extend NASA's heavy lift capability beyond the initial SLS Block 1 vehicle. The most noticeable change for this vehicle from SLS Block 1 is the swapping of the upper stage from the Interim Cryogenic Propulsion stage (ICPS), a modified Delta IV upper stage, to the more capable Exploration Upper Stage (EUS). As the vehicle evolves to provide greater lift capability and execute more demanding missions so must the SLS Integrated Navigation System to support those missions. The SLS Block 1 vehicle carries two independent navigation systems. The responsibility of the two systems is delineated between ascent and upper stage flight. The Block 1 navigation system is responsible for the phase of flight between the launch pad and insertion into Low-Earth Orbit (LEO). The upper stage system assumes the mission from LEO to payload separation. For the Block 1B vehicle, the two functions are combined into a single system intended to navigate from ground to payload insertion. Both are responsible for self-disposal once payload delivery is achieved. The evolution of the navigation hardware and algorithms from an inertial-only navigation system for Block 1 ascent flight to a tightly coupled GPS-aided inertial navigation system for Block 1-B is described. The Block 1 GN&C system has been designed to meet a LEO insertion target with a specified accuracy. The Block 1-B vehicle navigation system is designed to support the Block 1 LEO target accuracy as well as trans-lunar or trans-planetary injection accuracy. This is measured in terms of payload impact and stage disposal requirements. Additionally, the Block 1-B vehicle is designed to support human exploration and thus is designed to minimize the probability of Loss of Crew (LOC) through high-quality inertial instruments and Fault Detection, Isolation, and Recovery (FDIR) logic. The preliminary Block 1B integrated navigation system design is presented along with the challenges associated with

Simulink Model of the Ares I Upper Stage Main Propulsion System

NASA Technical Reports Server (NTRS)

Burchett, Bradley T.

2008-01-01

A numerical model of the Ares I upper stage main propulsion system is formulated based on first principles. Equation's are written as non-linear ordinary differential equations. The GASP fortran code is used to compute thermophysical properties of the working fluids. Complicated algebraic constraints are numerically solved. The model is implemented in Simulink and provides a rudimentary simulation of the time history of important pressures and temperatures during re-pressurization, boost and upper stage firing. The model is validated against an existing reliable code, and typical results are shown.

Maturation of enabling technologies for the next generation reignitable cryogenic upper stage

NASA Astrophysics Data System (ADS)

Mueller, Mark

Following the ESA decision in November 2008, a pre-development phase (Phase 1) of a future evolution of the Ariane 5 launcher (named Ariane 5 Midlife Evolution, A5ME) was started under Astrium Prime leadership. This upgraded version of the Ariane 5 launcher is based on an enhanced performance Upper Stage including the cryogenic re-ignitable VINCI engine. Thanks to this reignition capability, this new Upper Stage shall be "versatile" in the sense that it shall fulfil customer needs on a broader spectrum of orbits than the "standard" orbits (i.e. Geosynchronous Transfer Orbits, GTO) typically used for commercial telecommunications satellites. In order to meet the challenges of versatility, new technologies are currently being investigated. These technologies are mainly related -but not limited-to propellant management during the extended coasting phases with the related heat transfer into the tanks and the required multiple engine re-ignitions. Within the frame of the ESA Future Launchers Preparatory Programme (Period 2 Slice 1), the Cryogenic Upper Stage Technology project (CUST) aims to mature critical technologies to such a Technology Readiness Level (TRL) that they can be integrated into the baseline A5ME Upper Stage development schedule. In addition to A5ME application, these technologies can also be used on the future next generation European launcher. This paper shows the down-selection process implemented to identify the most crucial enabling technologies for a future versatile Upper Stage and gives a description of each technology finally selected for maturation in the frame of CUST. These include -amongst others-a Sandwich Common Bulkhead for the propellant tank, an external thermal insulation kit and various propellant management devices for the coasting phase. The paper also gives an overview on the related development and maturation plan including the tests to be conducted, as well as first results of the maturation activities themselves.

Vorinostat, Rituximab, and Combination Chemotherapy in Treating Patients With Newly Diagnosed Stage II, Stage III, or Stage IV Diffuse Large B-Cell Lymphoma

ClinicalTrials.gov

2017-09-12

Stage II Contiguous Adult Diffuse Large Cell Lymphoma; Stage II Non-Contiguous Adult Diffuse Large Cell Lymphoma; Stage III Adult Diffuse Large Cell Lymphoma; Stage IV Adult Diffuse Large Cell Lymphoma

Creation of an Upper Stage Trajectory Capability Boundary to Enable Booster System Trade Space Exploration

NASA Technical Reports Server (NTRS)

Walsh, Ptrick; Coulon, Adam; Edwards, Stephen; Mavris, Dimitri N.

2012-01-01

The problem of trajectory optimization is important in all space missions. The solution of this problem enables one to specify the optimum thrust steering program which should be followed to achieve a specified mission objective, simultaneously satisfying the constraints.1 It is well known that whether or not the ascent trajectory is optimal can have a significant impact on propellant usage for a given payload, or on payload weight for the same gross vehicle weight.2 Consequently, ascent guidance commands are usually optimized in some fashion. Multi-stage vehicles add complexity to this analysis process as changes in vehicle properties in one stage propagate to the other stages through gear ratios and changes in the optimal trajectory. These effects can cause an increase in analysis time as more variables are added and convergence of the optimizer to system closure requires more analysis iterations. In this paper, an approach to simplifying this multi-stage problem through the creation of an upper stage capability boundary is presented. This work was completed as part of a larger study focused on trade space exploration for the advanced booster system that will eventually form a part of NASA s new Space Launch System.3 The approach developed leverages Design of Experiments and Surrogate Modeling4 techniques to create a predictive model of the SLS upper stage performance. The design of the SLS core stages is considered fixed for the purposes of this study, which results in trajectory parameters such as staging conditions being the only variables relevant to the upper stage. Through the creation of a surrogate model, which takes staging conditions as inputs and predicts the payload mass delivered by the SLS upper stage to a reference orbit as the response, it is possible to identify a "surface" of staging conditions which all satisfy the SLS requirement of placing 130 metric tons into low-Earth orbit (LEO).3 This identified surface represents the 130 metric ton

Orbit decay analysis of STS upper stage boosters

NASA Technical Reports Server (NTRS)

Graf, O. F., Jr.; Mueller, A. C.

1979-01-01

An orbit decay analysis of the space transportation system upper stage boosters is presented. An overview of the computer trajectory programs, DSTROB, algorithm is presented. Atmospheric drag and perturbation models are described. The development of launch windows, such that the transfer orbit will decay within two years, is discussed. A study of the lifetimes of geosynchronous transfer orbits is presented.

Modeling and Simulation of the ARES UPPER STAGE Transportation, Lifting, Stacking and Mating Operations Within the Vehicle Assembly Building at KSC

NASA Technical Reports Server (NTRS)

Kromis, Phillip A.

2010-01-01

This viewgraph presentation describes the modeling and simulation of the Ares Upper Stage Transportation, lifting, stacking, and mating operations within the Vehicle Assembly Building (VAB) at Kennedy Space Center (KSC). An aerial view of KSC Launch Shuttle Complex, two views of the Delmia process control layout, and an upper stage move subroutine and breakdown are shown. An overhead image of the VAB and the turning basin along with the Pegasus barge at the turning basin are also shown. This viewgraph presentation also shows the actual design and the removal of the mid-section spring tensioners, the removal of the AFT rear and forward tensioners tie downs, and removing the AFT hold down post and mount. US leaving the Pegasus Barge, the upper stage arriving at transfer aisle, upper stage receiving/inspection in transfer aisle, and an overhead view of upper stage receiving/inspection in transfer aisle are depicted. Five views of the actual connection of the cabling to the upper stage aft lifting hardware are shown. The upper stage transporter forward connector, two views of the rotation horizontal to vertical, the disconnection of the rear bolt ring cabling, the lowering of the upper stage to the inspection stand, disconnection of the rear bolt ring from the upper stage, the lifting of the upper stage and inspection of AFT fange, and the transfer of upper stage in an integrated stack are shown. Six views of the mating of the upper stage to the first stage are depicted. The preparation, inspection, and removal of the forward dome are shown. The upper stage mated on the integrated stack and crawler is also shown. This presentation concludes with A Rapid Upper Limb Assessment (RULA) utilizing male and female models for assessing risk factors to the upper extremities of human beings in an actual physical environment.

NASA Ares I Crew Launch Vehicle Upper Stage Overview

NASA Technical Reports Server (NTRS)

Davis, Daniel J.

2008-01-01

By incorporating rigorous engineering practices, innovative manufacturing processes and test techniques, a unique multi-center government/contractor partnership, and a clean-sheet design developed around the primary requirements for the International Space Station (ISS) and Lunar missions, the Upper Stage Element of NASA's Crew Launch Vehicle (CLV), the "Ares I," is a vital part of the Constellation Program's transportation system. Constellation's exploration missions will include Ares I and Ares V launch vehicles required to place crew and cargo in low-Earth orbit (LEO), crew and cargo transportation systems required for human space travel, and transportation systems and scientific equipment required for human exploration of the Moon and Mars. Early Ares I configurations will support ISS re-supply missions. A self-supporting cylindrical structure, the Ares I Upper Stage will be approximately 84' long and 18' in diameter. The Upper Stage Element is being designed for increased supportability and increased reliability to meet human-rating requirements imposed by NASA standards. The design also incorporates state-of-the-art materials, hardware, design, and integrated logistics planning, thus facilitating a supportable, reliable, and operable system. With NASA retiring the Space Shuttle fleet in 2010, the success of the Ares I Project is essential to America's continued leadership in space. The first Ares I test flight, called Ares 1-X, is scheduled for 2009. Subsequent test flights will continue thereafter, with the first crewed flight of the Crew Exploration Vehicle (CEV), "Orion," planned for no later than 2015. Crew transportation to the ISS will follow within the same decade, and the first Lunar excursion is scheduled for the 2020 timeframe.

NASA Ares I Crew Launch Vehicle Upper Stage Overview

NASA Technical Reports Server (NTRS)

McArthur, J. Craig

2008-01-01

By incorporating rigorous engineering practices, innovative manufacturing processes and test techniques, a unique multi-center government/contractor partnership, and a clean-sheet design developed around the primary requirements for the International Space Station (ISS) and Lunar missions, the Upper Stage Element of NASA's Crew Launch Vehicle (CLV), the "Ares I," is a vital part of the Constellation Program's transportation system. Constellation's exploration missions will include Ares I and Ares V launch vehicles required to place crew and cargo in low-Earth orbit (LEO), crew and cargo transportation systems required for human space travel, and transportation systems and scientific equipment required for human exploration of the Moon and Mars. Early Ares I configurations will support ISS re-supply missions. A self-supporting cylindrical structure, the Ares I Upper Stage will be approximately 84' long and 18' in diameter. The Upper Stage Element is being designed for increased supportability and increased reliability to meet human-rating requirements imposed by NASA standards. The design also incorporates state-of-the-art materials, hardware, design, and integrated logistics planning, thus facilitating a supportable, reliable, and operable system. With NASA retiring the Space Shuttle fleet in 2010, the success of the Ares I Project is essential to America's continued leadership in space. The first Ares I test flight, called Ares I-X, is scheduled for 2009. Subsequent test flights will continue thereafter, with the first crewed flight of the Crew Exploration Vehicle (CEV), "Orion," planned for no later than 2015. Crew transportation to the ISS will follow within the same decade, and the first Lunar excursion is scheduled for the 2020 timeframe.

Upper Airway Collapsibility (Pcrit) and Pharyngeal Dilator Muscle Activity are Sleep Stage Dependent

PubMed Central

Carberry, Jayne C.; Jordan, Amy S.; White, David P.; Wellman, Andrew; Eckert, Danny J.

2016-01-01

Study Objectives: An anatomically narrow/highly collapsible upper airway is the main cause of obstructive sleep apnea (OSA). Upper airway muscle activity contributes to airway patency and, like apnea severity, can be sleep stage dependent. Conversely, existing data derived from a small number of participants suggest that upper airway collapsibility, measured by the passive pharyngeal critical closing pressure (Pcrit) technique, is not sleep stage dependent. This study aimed to determine the effect of sleep stage on Pcrit and upper airway muscle activity in a larger cohort than previously tested. Methods: Pcrit and/or muscle data were obtained from 72 adults aged 20–64 y with and without OSA.Pcrit was determined via transient reductions in continuous positive airway pressure (CPAP) during N2, slow wave sleep (SWS) and rapid eye movement (REM) sleep. Genioglossus and tensor palatini muscle activities were measured: (1) awake with and without CPAP, (2) during stable sleep on CPAP, and (3) in response to the CPAP reductions used to quantify Pcrit. Results: Pcrit was 4.9 ± 1.4 cmH2O higher (more collapsible) during REM versus SWS (P = 0.012), 2.3 ± 0.6 cmH2O higher during REM versus N2 (P < 0.001), and 1.6 ± 0.7 cmH2O higher in N2 versus SWS (P = 0.048). Muscle activity decreased from wakefulness to sleep and from SWS to N2 to REM sleep for genioglossus but not for tensor palatini. Pharyngeal muscle activity increased by ∼50% by breath 5 following CPAP reductions. Conclusions: Upper airway collapsibility measured via the Pcrit technique and genioglossus muscle activity vary with sleep stage. These findings should be taken into account when performing and interpreting “passive” Pcrit measurements. Citation: Carberry JC, Jordan AS, White DP, Wellman A, Eckert DJ. Upper airway collapsibility (Pcrit) and pharyngeal dilator muscle activity are sleep stage dependent. SLEEP 2016;39(3):511–521. PMID:26612386

Prognostic implication of serum hepatocyte growth factor in stage II/III breast cancer patients who received neoadjuvant chemotherapy.

PubMed

Kim, Hyori; Youk, Jeonghwan; Yang, Yaewon; Kim, Tae-Yong; Min, Ahrum; Ham, Hye-Seon; Cho, Seongcheol; Lee, Kyung-Hun; Keam, Bhumsuk; Han, Sae-Won; Oh, Do-Youn; Ryu, Han Suk; Han, Wonshik; Park, In Ae; Kim, Tae-You; Noh, Dong-Young; Im, Seock-Ah

2016-03-01

In stage II/III breast cancer, neoadjuvant chemotherapy (NAC) is a standard treatment. Although several biomarkers are used to predict prognosis in breast cancer, there is no reliable predictive biomarker for NAC success. Recently, the hepatocyte growth factor (HGF) and cMet signaling pathway demonstrated to be involved in breast cancer tumor progression, and its potential as a biomarker is under active investigation. In this study, we assessed the potential of serum HGF as a prognostic biomarker for NAC efficacy. Venous blood samples were drawn from patients diagnosed with stage II/III breast cancer and treated with NAC in Seoul National University Hospital from August 2004 to November 2009. Serum HGF level was determined using an ELISA system. We reviewed the medical records of the patients and investigated the association of HGF level with patients' clinicopathologic characteristics. A total of 121 female patients (median age = 45 years old) were included. Median level of HGF was 934 pg/ml (lower quartile: 772, upper quartile: 1145 pg/ml). Patients with higher HGF level than median value were significantly more likely to have clinically detectable regional node metastasis (p = 0.017, Fisher's exact test). Patients with complete and partial response according to the American Joint Committee on Cancer 7th Edition criteria tended to have higher HGF level (p = 0.105 by t test). Patients with an HGF level higher than the upper quartile value had longer relapse-free survival than the other patients (106 vs. 85 months, p = 0.008). High serum HGF levels in breast cancer patients are associated with clinically detectable regional node metastasis and, paradoxically, with longer relapse-free survival in stage II/III breast cancer.

Multiple Removal of Spent Rocket Upper Stages with an Ion Beam Shepherd

NASA Astrophysics Data System (ADS)

Bombardelli, C.; Herrera-Montojo, J.; Gonzalo, J. L.

2013-08-01

Among the many advantages of the recently proposed ion beam shepherd (IBS) debris removal technique is the capability to deal with multiple targets in a single mission. A preliminary analysis is here conducted in order to estimate the cost in terms of spacecraft mass and total mission time to remove multiple large-size upper stages of the Zenit family. Zenit-2 upper stages are clustered at 71 degrees inclination around 850 km altitude in low Earth orbit. It is found that a removal of two targets per year is feasible with a modest size spacecraft. The most favorable combinations of targets are outlined.

Physics Identity Development: A Snapshot of the Stages of Development of Upper-Level Physics Students

ERIC Educational Resources Information Center

Irving, Paul W.; Sayre, Eleanor C.

2013-01-01

As part of a longitudinal study into identity development in upper-level physics students a phenomenographic research method is employed to assess the stages of identity development of a group of upper-level students. Three categories of description were discovered which indicate the three different stages of identity development for this group…

The Inertial Upper Stage - Flight experience and capabilities

NASA Astrophysics Data System (ADS)

Kuhns, Randall H.; Maricich, Peter L.; Bangsund, Edward L.; Friske, Stephen A.; Hallman, Wayne P.; Goldstein, Allen E.

1993-10-01

The Inertial Upper Stage (IUS) is a two-stage rocket designed to place a variety of payloads in high earth orbit or on interplanetary trajectories, which has been boosted to date, together with its payloads, from the earth's surface to low altitude park orbits by the USAF Titan launcher and the NASA Space Shuttle. This paper discusses the IUS redundancy and presents data on the value of the IST's redundant design and the past uses of the vehicle's redundant capability to achieve mission success. The value of IUS's redundancy has been confirmed on several flights. The paper presents block diagrams of the IUS redundancy architecture and of the redundancy hardware switching and commands.

Lessons Learned from Ares I Upper Stage Structures and Thermal Design

NASA Technical Reports Server (NTRS)

Ahmed, Rafiq

2012-01-01

The Ares 1 Upper Stage was part of the vehicle intended to succeed the Space Shuttle as the United States manned spaceflight vehicle. Although the Upper Stage project was cancelled, there were many lessons learned that are applicable to future vehicle design. Lessons learned that are briefly detailed in this Technical Memorandum are for specific technical areas such as tank design, common bulkhead design, thrust oscillation, control of flight and slosh loads, purge and hazardous gas system. In addition, lessons learned from a systems engineering and vehicle integration perspective are also included, such as computer aided design and engineering, scheduling, and data management. The need for detailed systems engineering in the early stages of a project is emphasized throughout this report. The intent is that future projects will be able to apply these lessons learned to keep costs down, schedules brief, and deliver products that perform to the expectations of their customers.

Ares I-X Upper Stage Simulator Residual Stress Analysis

NASA Technical Reports Server (NTRS)

Raju, Ivatury S.; Brust, Frederick W.; Phillips, Dawn R.; Cheston, Derrick

2008-01-01

The structural analyses described in the present report were performed in support of the NASA Engineering and Safety Center (NESC) Critical Initial Flaw Size (CIFS) assessment for the Ares I-X Upper Stage Simulator (USS) common shell segment. An independent assessment was conducted to determine the critical initial flaw size (CIFS) for the flange-to-skin weld in the Ares I-X Upper Stage Simulator (USS). The Ares system of space launch vehicles is the US National Aeronautics and Space Administration s plan for replacement of the aging space shuttle. The new Ares space launch system is somewhat of a combination of the space shuttle system and the Saturn launch vehicles used prior to the shuttle. Here, a series of weld analyses are performed to determine the residual stresses in a critical region of the USS. Weld residual stresses both increase constraint and mean stress thereby having an important effect on fatigue and fracture life. The results of this effort served as one of the critical load inputs required to perform a CIFS assessment of the same segment.

The Malemute development program. [rocket upper stage engine design

NASA Technical Reports Server (NTRS)

Bolster, W. J.; Hoekstra, P. W.

1976-01-01

The Malemute vehicle systems are two-stage systems based on utilizing a new high performance upper stage motor with two existing military boosters. The Malmute development program is described relative to program structure, preliminary design, vehicle subsystems, and the Malemute motor. Two vehicle systems, the Nike-Malemute and Terrier-Malemute, were developed which are capable of transporting comparatively large diameter (16 in.) 200-lb payloads to altitudes of 500 and 700 km, respectively. These vehicles provide relatively low-cost transportation with two-stage reliability and launch simplicity. Flight tests of both vehicle systems revealed their performance capabilities, with the Terrier-Malemute system involving a unique Malemute motor spin sensitivity problem. It is suggested that the vehicles can be successfully flown by lowering the burnout spin rate.

Integrated Solar Upper Stage Technical Support

NASA Technical Reports Server (NTRS)

Jaworske, Donald A.

1998-01-01

NASA Lewis Research Center is participating in the Integrated Solar Upper Stage (ISUS) program. This program is a ground-based demonstration of an upper stage concept that will be used to generate both solar propulsion and solar power. Solar energy collected by a primary concentrator is directed into the aperture of a secondary concentrator and further concentrated into the aperture of a heat receiver. The energy stored in the receiver-absorber-converter is used to heat hydrogen gas to provide propulsion during the orbital transfer portion of the mission. During the balance of the mission, electric power is generated by thermionic diodes. Several materials issues were addressed as part of the technical support portion of the ISUS program, including: 1) Evaluation of primary concentrator coupons; 2) Evaluation of secondary concentrator coupons; 3) Evaluation of receiver-absorber-converter coupons; 4) Evaluation of in-test witness coupons. Two different types of primary concentrator coupons were evaluated from two different contractors-replicated coupons made from graphite-epoxy composite and coupons made from microsheet glass. Specular reflectivity measurements identified the replicated graphite-epoxy composite coupons as the primary concentrator material of choice. Several different secondary concentrator materials were evaluated, including a variety of silver and rhodium reflectors. The specular reflectivity of these materials was evaluated under vacuum at temperatures up to 800 C. The optical properties of several coupons of rhenium on graphite were evaluated to predict the thermal performance of the receiver-absorber-converter. Finally, during the ground test demonstration, witness coupons placed in strategic locations throughout the thermal vacuum facility were evaluated for contaminants. All testing for the ISUS program was completed successfully in 1997. Investigations related to materials issues have proven helpful in understanding the operation of the test

Carboplatin and Paclitaxel With or Without Cisplatin and Radiation Therapy in Treating Patients With Stage I, Stage II, Stage III, or Stage IVA Endometrial Cancer

ClinicalTrials.gov

2018-01-09

Endometrial Clear Cell Adenocarcinoma; Endometrial Serous Adenocarcinoma; Stage IA Uterine Corpus Cancer; Stage IB Uterine Corpus Cancer; Stage II Uterine Corpus Cancer; Stage IIIA Uterine Corpus Cancer; Stage IIIB Uterine Corpus Cancer; Stage IIIC Uterine Corpus Cancer; Stage IVA Uterine Corpus Cancer

Relationship between stage II transport and number of chewing strokes as mastication progresses.

PubMed

Yamashita, Shuichiro; Sugita, Daisuke; Matsuo, Koichiro

2013-10-02

As mastication progresses, little is known about the occurrence of the stage II transport (oro-pharyngeal bolus transport). This study aimed to investigate the relationship between stage II transport and bolus aggregation in the pharynx and the number of chewing strokes. Twenty-five clinical residents with natural dentitions were recruited. The subjects were asked to chew gummy jelly with their preferred rhythm and to swallow the bolus at their preferred timing. To investigate stage II transport and bolus aggregation in the pharynx, a transnasal endoscope was used. The number of chewing strokes was measured by electromyographic activity from the masseter muscle. The mean numbers of chewing strokes of pre-stage II transport and post-stage II transport were 29.8 and 8.1, respectively; the difference was significant (p<0.01). The ratio of the number of chewing strokes of pre-stage II transport to that of post-stage II transport was 4.0 to 1.0. This study showed that stage II transport started at four-fifths of the way along the progress of mastication, and that stage II transport and bolus aggregation in the pharynx are related to the number of chewing strokes. © 2013. Published by Elsevier Inc. All rights reserved.

Imatinib Mesylate in Treating Patients With Progressive, Refractory, or Recurrent Stage II or Stage III Testicular or Ovarian Cancer

ClinicalTrials.gov

2013-01-15

Ovarian Dysgerminoma; Recurrent Malignant Testicular Germ Cell Tumor; Recurrent Ovarian Germ Cell Tumor; Stage II Malignant Testicular Germ Cell Tumor; Stage II Ovarian Germ Cell Tumor; Stage III Malignant Testicular Germ Cell Tumor; Stage III Ovarian Germ Cell Tumor; Testicular Seminoma

Upper Stage Flight Experiment 10K Engine Design and Test Results

NASA Technical Reports Server (NTRS)

Ross, R.; Morgan, D.; Crockett, D.; Martinez, L.; Anderson, W.; McNeal, C.

2000-01-01

A 10,000 lbf thrust chamber was developed for the Upper Stage Flight Experiment (USFE). This thrust chamber uses hydrogen peroxide/JP-8 oxidizer/fuel combination. The thrust chamber comprises an oxidizer dome and manifold, catalyst bed assembly, fuel injector, and chamber/nozzle assembly. Testing of the engine was done at NASA's Stennis Space Center (SSC) to verify its performance and life for future upper stage or Reusable Launch Vehicle applications. Various combinations of silver screen catalyst beds, fuel injectors, and combustion chambers were tested. Results of the tests showed high C* efficiencies (97% - 100%) and vacuum specific impulses of 275 - 298 seconds. With fuel film cooling, heating rates were low enough that the silica/quartz phenolic throat experienced minimal erosion. Mission derived requirements were met, along with a perfect safety record.

NASA Ares I Crew Launch Vehicle Upper Stage Overview

NASA Technical Reports Server (NTRS)

Davusm Daniel J.; McArthur, J. Craig

2008-01-01

By incorporating rigorous engineering practices, innovative manufacturing processes and test techniques, a unique multi-center government/contractor partnership, and a clean-sheet design developed around the primary requirements for the International Space Station (ISS) and Lunar missions, the Upper Stage Element of NASA's Crew Launch Vehicle (CLV), the "Ares I," is a vital part of the Constellation Program's transportation system.

Comparative evaluation of existing expendable upper stages for space shuttle

NASA Technical Reports Server (NTRS)

Weyers, V. J.; Sagerman, G. D.; Borsody, J.; Lubick, R. J.

1974-01-01

The use of existing expendable upper stages in the space shuttle during its early years of operation is evaluated. The Burner 2, Scout, Delta, Agena, Transtage, and Centaur were each studied under contract by their respective manufacturers to determine the extent and cost of the minimum modifications necessary to integrate the stage with the shuttle orbiter. A comparative economic analysis of thirty-five different families of these stages is discussed. Results show that the overall transportation system cost differences between many of the families are quite small. However, by considering several factors in addition to cost, it is possible to select one family as being representative of the capability of the minimum modification existing stage approach. The selected family meets all of the specified mission requirements during the early years of shuttle operation.

Subsystem Hazard Analysis Methodology for the Ares I Upper Stage Source Controlled Items

NASA Technical Reports Server (NTRS)

Mitchell, Michael S.; Winner, David R.

2010-01-01

This article describes processes involved in developing subsystem hazard analyses for Source Controlled Items (SCI), specific components, sub-assemblies, and/or piece parts, of the NASA ARES I Upper Stage (US) project. SCIs will be designed, developed and /or procured by Boeing as an end item or an off-the-shelf item. Objectives include explaining the methodology, tools, stakeholders and products involved in development of these hazard analyses. Progress made and further challenges in identifying potential subsystem hazards are also provided in an effort to assist the System Safety community in understanding one part of the ARES I Upper Stage project.

System Characterization of MAHI EXO-II: A Robotic Exoskeleton for Upper Extremity Rehabilitation.

PubMed

French, James A; Rose, Chad G; O'Malley, Marcia K

2014-10-01

This paper presents the performance characterization of the MAHI Exo-II, an upper extremity exoskeleton for stroke and spinal cord injury (SCI) rehabilitation, as a means to validate its clinical implementation and to provide depth to the literature on the performance characteristics of upper extremity exoskeletons. Individuals with disabilities arising from stroke and SCI need rehabilitation of the elbow, forearm, and wrist to restore the ability to independently perform activities of daily living (ADL). Robotic rehabilitation has been proposed to address the need for high intensity, long duration therapy and has shown promising results for upper limb proximal joints. However, upper limb distal joints have historically not benefitted from the same focus. The MAHI Exo-II, designed to address this shortcoming, has undergone a static and dynamic performance characterization, which shows that it exhibits the requisite qualities for a rehabilitation robot and is comparable to other state-of-the-art designs.

Propellant Management in Booster and Upper Stage Propulsion Systems

NASA Technical Reports Server (NTRS)

Fisher, Mark F.

1997-01-01

A summary review of some of the technical issues which surround the design of the propulsion systems for Booster and Upper Stage systems are presented. The work focuses on Propellant Geyser, Slosh, and Orientation. A brief description of the concern is given with graphics which help the reader to understand the physics of the situation. The most common solutions to these problems are given with there respective advantages and disadvantages.

Contemporary management of stage I and II seminoma.

PubMed

Chung, Peter; Warde, Padraig

2013-10-01

Seminoma represents about 60 % of all testicular germ cell tumors. At presentation about 80 % of patients have stage I and about 15 % have stage II disease. The last three decades have seen a substantial change in the philosophy of management with the success of surveillance as a strategy to minimize unnecessary treatment, recognition of the late effects of radiation therapy, and the success of cisplatin-based chemotherapy as curative treatment either in the first-line or salvage setting. Overall, in stage I disease where 80-85 % are cured with orchiectomy alone, efforts now are directed at reducing the burden of the disease and its diagnosis on patients with increasing utilization of surveillance and decreased employment of adjuvant therapy. For stage II disease, balancing the relative toxicities of radiation and chemotherapy while avoiding the use of multimodality therapy due to the additive long-term toxicity has become the priority.

System Characterization of MAHI EXO-II: A Robotic Exoskeleton for Upper Extremity Rehabilitation

PubMed Central

French, James A.; Rose, Chad G.; O'Malley, Marcia K.

2015-01-01

This paper presents the performance characterization of the MAHI Exo-II, an upper extremity exoskeleton for stroke and spinal cord injury (SCI) rehabilitation, as a means to validate its clinical implementation and to provide depth to the literature on the performance characteristics of upper extremity exoskeletons. Individuals with disabilities arising from stroke and SCI need rehabilitation of the elbow, forearm, and wrist to restore the ability to independently perform activities of daily living (ADL). Robotic rehabilitation has been proposed to address the need for high intensity, long duration therapy and has shown promising results for upper limb proximal joints. However, upper limb distal joints have historically not benefitted from the same focus. The MAHI Exo-II, designed to address this shortcoming, has undergone a static and dynamic performance characterization, which shows that it exhibits the requisite qualities for a rehabilitation robot and is comparable to other state-of-the-art designs. PMID:25984380

From Paper to Production: An Update on NASA's Upper Stage Engine for Exploration

NASA Technical Reports Server (NTRS)

Kynard, Mike

2010-01-01

In 2006, NASA selected an evolved variant of the proven Saturn/Apollo J-2 upper stage engine to power the Ares I crew launch vehicle upper stage and the Ares V cargo launch vehicle Earth departure stage (EDS) for the Constellation Program. Any design changes needed by the new engine would be based where possible on proven hardware from the Space Shuttle, commercial launchers, and other programs. In addition to the thrust and efficiency requirements needed for the Constellation reference missions, it would be an order of magnitude safer than past engines. It required the J-2X government/industry team to develop the highest performance engine of its type in history and develop it for use in two vehicles for two different missions. In the attempt to achieve these goals in the past five years, the Upper Stage Engine team has made significant progress, successfully passing System Requirements Review (SRR), System Design Review (SDR), Preliminary Design Review (PDR), and Critical Design Review (CDR). As of spring 2010, more than 100,000 experimental and development engine parts have been completed or are in various stages of manufacture. Approximately 1,300 of more than 1,600 engine drawings have been released for manufacturing. This progress has been due to a combination of factors: the heritage hardware starting point, advanced computer analysis, and early heritage and development component testing to understand performance, validate computer modeling, and inform design trades. This work will increase the odds of success as engine team prepares for powerpack and development engine hot fire testing in calendar 2011. This paper will provide an overview of the engine development program and progress to date.

Radiation Therapy and Cisplatin With or Without Triapine in Treating Patients With Newly Diagnosed Stage IB2, II, or IIIB-IVA Cervical Cancer or Stage II-IVA Vaginal Cancer

ClinicalTrials.gov

2018-06-20

Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Squamous Cell Carcinoma, Not Otherwise Specified; Stage IB2 Cervical Cancer AJCC v6 and v7; Stage II Cervical Cancer AJCC v7; Stage II Vaginal Cancer AJCC v6 and v7; Stage IIA Cervical Cancer AJCC v7; Stage IIB Cervical Cancer AJCC v6 and v7; Stage III Vaginal Cancer AJCC v6 and v7; Stage IIIB Cervical Cancer AJCC v6 and v7; Stage IVA Cervical Cancer AJCC v6 and v7; Stage IVA Vaginal Cancer AJCC v6 and v7; Vaginal Adenocarcinoma; Vaginal Adenosquamous Carcinoma; Vaginal Squamous Cell Carcinoma, Not Otherwise Specified

Development and Testing of Carbon-Carbon Nozzle Extensions for Upper Stage Liquid Rocket Engines

NASA Technical Reports Server (NTRS)

Valentine, Peter G.; Gradl, Paul R.; Greene, Sandra E.

2017-01-01

Carbon-carbon (C-C) composite nozzle extensions are of interest for use on a variety of launch vehicle upper stage engines and in-space propulsion systems. The C-C nozzle extension technology and test capabilities being developed are intended to support National Aeronautics and Space Administration (NASA) and Department of Defense (DOD) requirements, as well as those of the broader Commercial Space industry. For NASA, C-C nozzle extension technology development primarily supports the NASA Space Launch System (SLS) and NASA's Commercial Space partners. Marshall Space Flight Center (MSFC) efforts are aimed at both (a) further developing the technology and databases needed to enable the use of composite nozzle extensions on cryogenic upper stage engines, and (b) developing and demonstrating low-cost capabilities for testing and qualifying composite nozzle extensions. Recent, on-going, and potential future work supporting NASA, DOD, and Commercial Space needs will be discussed. Information to be presented will include (a) recent and on-going mechanical, thermal, and hot-fire testing, as well as (b) potential future efforts to further develop and qualify domestic C-C nozzle extension solutions for the various upper stage engines under development.

Tracking an upper limit of the "Carnian Crisis" and/or Carnian stage in the Western Carpathians (Slovakia)

NASA Astrophysics Data System (ADS)

Kohút, Milan; Hofmann, Mandy; Havrila, Milan; Linnemann, Ulf; Havrila, Jakub

2018-01-01

The Late Triassic timescale, especially the Carnian-Norian boundary, is poorly constrained mainly due to a paucity of high-precision radio-isotopic ages that can be related accurately to contradictions between the biostratigraphic and magnetostratigraphic correlations. LA ICP-MS dating of detrital zircons from five samples of the Lunz Formation—the Upper Triassic siliciclastic sediments from the Western Carpathians (Slovakia)—provided a wide spectrum of ages that vary from Late Archaean (ca. 2582 Ma) to Triassic (ca. 216 Ma). These marine delta sediments represent a typical product of the "Carnian Crisis"—a major climate change and biotic turnover that occurred during the Carnian stage in the Tethys Ocean within the carbonate shelf and intrashelf basins in the Northern Calcareous Alps and the Western Carpathians. The supply of clastic material in the studied Lunz Formation was derived from several sources, especially: (i) from the recycled Variscan orogen; (ii) from the remote East European Platform; and (iii) from the contemporaneous Triassic volcanic sources. Syn-sedimentary volcanic zircons with a concordia age of 221.2 ± 1.6 Ma (calculated from 12 single analyses) represent the maximum age of deposition of the Lunz Formation, and demonstrate that the upper limit of the "Carnian Crisis" and/or the Carnian stage in the Alpine-Carpathians realm is younger than the current age of the Carnian-Norian boundary at ca. 227 Ma listed on the International Chronostratigraphic Chart (International Commission on Stratigraphy 2016/12 Edition).

Waterhammer Testing and Modeling of the Ares I Upper Stage Reaction Control System

NASA Technical Reports Server (NTRS)

Williams, J. Hunter; Holt, Kimberly A.

2010-01-01

NASA's Ares I rocket is the agency's first step in completing the goals of the Constellation Program, which plans to deliver a new generation of space explorers into low earth orbit for future missions to the International Space Station, the moon, and other destinations within the solar system. Ares I is a two-stage rocket topped by the Orion crew capsule and its service module. The launch vehicle's First Stage is a single, five-segment reusable solid rocket booster (RSRB), derived from the Space Shuttle Program's four segment RSRB. The vehicle's Upper Stage, being designed at Marshall Space Flight Center (MSFC), is propelled by a single J-2X Main Engine fueled with liquid oxygen and liquid hydrogen. During active Upper Stage flight of the Ares I launch vehicle, the Upper Stage Reaction Control System (US ReCS) will perform attitude control operations for the vehicle. The US ReCS will provide three-axis attitude control capability (roll, pitch, and yaw) for the Upper Stage while the J-2X is not firing and roll control capability while the engine is firing. Because of the requirements imposed upon the system, the design must accommodate rapid pulsing of multiple thrusters simultaneously to maintain attitude control. In support of these design activities and in preparation for Critical Design Review, analytical models of the US ReCS propellant feed system have been developed using the Thermal Hydraulic Library of MSC.EASY5 v.2008, herein referred to as EASY5. EASY5 is a commercially available fluid system modeling package with significant history of modeling space propulsion systems. In Fall 2009, a series of development tests were conducted at MSFC on a cold-flow test article for the US ReCS, herein referred to as System Development Test Article (SDTA). A subset of those tests performed were aimed at examining the effects of waterhammer on a flight-representative system and to ensure that those effects could be quantified with analytical models and incorporated into

Chemotherapy Toxicity On Quality of Life in Older Patients With Stage I, Stage II, Stage III, or Stage IV Ovarian Epithelial, Primary Peritoneal Cavity, or Fallopian Tube Cancer

ClinicalTrials.gov

2017-05-03

Stage I Ovarian Cancer; Stage IA Fallopian Tube Cancer; Stage IB Fallopian Tube Cancer; Stage IC Fallopian Tube Cancer; Stage II Ovarian Cancer; Stage IIA Fallopian Tube Cancer; Stage IIB Fallopian Tube Cancer; Stage IIC Fallopian Tube Cancer; Stage III Ovarian Cancer; Stage III Primary Peritoneal Cancer; Stage IIIA Fallopian Tube Cancer; Stage IIIB Fallopian Tube Cancer; Stage IIIC Fallopian Tube Cancer; Stage IV Fallopian Tube Cancer; Stage IV Ovarian Cancer; Stage IV Primary Peritoneal Cancer

Materials, Processes and Manufacturing in Ares 1 Upper Stage: Integration with Systems Design and Development

NASA Technical Reports Server (NTRS)

Bhat, Biliyar N.

2008-01-01

Ares I Crew Launch Vehicle Upper Stage is designed and developed based on sound systems engineering principles. Systems Engineering starts with Concept of Operations and Mission requirements, which in turn determine the launch system architecture and its performance requirements. The Ares I-Upper Stage is designed and developed to meet these requirements. Designers depend on the support from materials, processes and manufacturing during the design, development and verification of subsystems and components. The requirements relative to reliability, safety, operability and availability are also dependent on materials availability, characterization, process maturation and vendor support. This paper discusses the roles and responsibilities of materials and manufacturing engineering during the various phases of Ares IUS development, including design and analysis, hardware development, test and verification. Emphasis is placed how materials, processes and manufacturing support is integrated over the Upper Stage Project, both horizontally and vertically. In addition, the paper describes the approach used to ensure compliance with materials, processes, and manufacturing requirements during the project cycle, with focus on hardware systems design and development.

Adjuvant Therapy for Stage II Colorectal Cancer: Who and with What?

PubMed

Chung, Ki-Young Y; Kelsen, David

2006-06-01

The role of adjuvant chemotherapy for patients with stage II colon adenocarcinoma remains controversial. The high surgical cure rate for patients with "low-risk" stage II colon cancer, ranging from 75% to 80%, and the available clinical trials and meta-analyses provide conflicting recommendations for or against adjuvant chemotherapy for this group of patients. For fit "high-risk" stage II patients with clinical obstruction or perforation at presentation, in which the 5-year survival rate is 60% to 70%, there is little controversy, as these patients are routinely treated with adjuvant chemotherapy. Other potential high-risk factors, including high histologic grade, microsatellite instability, and loss of 18q, have yet to be validated in prospective trials. Patients with fewer than 12 regional lymph nodes identified in the surgical specimen have a statistically unclear risk of lymph node involvement. These patients may have stage III disease and should receive adjuvant therapy. The decision to use adjuvant chemotherapy to treat low-risk stage II colon cancer patients (no obstruction or perforation) should be an informed decision weighing the magnitude of a net 2% to 5% survival benefit, a 0.5% to 1.0% risk of mortality with chemotherapy in addition to 6 months of chemotherapy-related toxicities, other coexisting patient morbidities, and the anticipated life expectancy of each patient. As adjuvant chemotherapy is therapy addressing local or metastatic microscopic disease, and the effectiveness of systemic and biologically targeted therapy for advanced macroscopic colon cancer continues to improve rapidly, it remains to be determined by clinical trials whether therapies including newer agents such as cetuximab and bevacizumab administered in the adjuvant setting may affect survival for stage II cancer patients.

Waterhammer Modeling for the Ares I Upper Stage Reaction Control System Cold Flow Development Test Article

NASA Technical Reports Server (NTRS)

Williams, Jonathan H.

2010-01-01

The Upper Stage Reaction Control System provides three-axis attitude control for the Ares I launch vehicle during active Upper Stage flight. The system design must accommodate rapid thruster firing to maintain the proper launch trajectory and thus allow for the possibility to pulse multiple thrusters simultaneously. Rapid thruster valve closure creates an increase in static pressure, known as waterhammer, which propagates throughout the propellant system at pressures exceeding nominal design values. A series of development tests conducted in the fall of 2009 at Marshall Space Flight Center were performed using a water-flow test article to better understand fluid performance characteristics of the Upper Stage Reaction Control System. A subset of the tests examined waterhammer along with the subsequent pressure and frequency response in the flight-representative system and provided data to anchor numerical models. This thesis presents a comparison of waterhammer test results with numerical model and analytical results. An overview of the flight system, test article, modeling and analysis are also provided.

Waterhammer modeling for the Ares I Upper Stage Reaction Control System cold flow development test article

NASA Astrophysics Data System (ADS)

Williams, Jonathan Hunter

The Upper Stage Reaction Control System provides in-flight three-axis attitude control for the Ares I Upper Stage. The system design must accommodate rapid thruster firing to maintain proper launch trajectory and thus allow for the possibility to pulse multiple thrusters simultaneously. Rapid thruster valve closure creates an increase in static pressure, known as waterhammer, which propagates throughout the propellant system at pressures exceeding nominal design values. A series of development tests conducted at Marshall Space Flight Center in 2009 were performed using a water-flow test article to better understand fluid characteristics of the Upper Stage Reaction Control System. A subset of the tests examined the waterhammer pressure and frequency response in the flight-representative system and provided data to anchor numerical models. This thesis presents a comparison of waterhammer test results with numerical model and analytical results. An overview of the flight system, test article, modeling and analysis are also provided.

Assessment and Verification of SLS Block 1-B Exploration Upper Stage and Stage Disposal Performance

NASA Technical Reports Server (NTRS)

Patrick, Sean; Oliver, T. Emerson; Anzalone, Evan J.

2018-01-01

Delta-v allocation to correct for insertion errors caused by state uncertainty is one of the key performance requirements imposed on the SLS Navigation System. Additionally, SLS mission requirements include the need for the Exploration Up-per Stage (EUS) to be disposed of successfully. To assess these requirements, the SLS navigation team has developed and implemented a series of analysis methods. Here the authors detail the Delta-Delta-V approach to assessing delta-v allocation as well as the EUS disposal optimization approach.

Arrhythmias Following Comprehensive Stage II Surgical Palliation in Single Ventricle Patients.

PubMed

Wilhelm, Carolyn M; Paulus, Diane; Cua, Clifford L; Kertesz, Naomi J; Cheatham, John P; Galantowicz, Mark; Fernandez, Richard P

2016-03-01

Post-operative arrhythmias are common in pediatric patients following cardiac surgery. Following hybrid palliation in single ventricle patients, a comprehensive stage II palliation is performed. The incidence of arrhythmias in patients following comprehensive stage II palliation is unknown. The purpose of this study is to determine the incidence of arrhythmias following comprehensive stage II palliation. A single-center retrospective chart review was performed on all single ventricle patients undergoing a comprehensive stage II palliation from January 2010 to May 2014. Pre-operative, operative, and post-operative data were collected. A clinically significant arrhythmia was defined as an arrhythmia which led to cardiopulmonary resuscitation or required treatment with either pacing or antiarrhythmic medication. Statistical analysis was performed with Wilcoxon rank-sum test and Fisher's exact test with p < 0.05 significant. Forty-eight single ventricle patients were reviewed (32 hypoplastic left heart syndrome, 16 other single ventricle variants). Age at surgery was 185 ± 56 days. Cardiopulmonary bypass time was 259 ± 45 min. Average vasoactive-inotropic score was 5.97 ± 7.58. Six patients (12.5 %) had clinically significant arrhythmias: four sinus bradycardia, one 2:1 atrioventricular block, and one slow junctional rhythm. No tachyarrhythmias were documented for this patient population. Presence of arrhythmia was associated with elevated lactate (p = 0.04) and cardiac arrest (p = 0.002). Following comprehensive stage II palliation, single ventricle patients are at low risk for development of tachyarrhythmias. The most frequent arrhythmia seen in these patients was sinus bradycardia associated with respiratory compromise.

The J-2X Upper Stage Engine: From Heritage to Hardware

NASA Technical Reports Server (NTRS)

Byrd, THomas

2008-01-01

NASA's Global Exploration Strategy requires safe, reliable, robust, efficient transportation to support sustainable operations from Earth to orbit and into the far reaches of the solar system. NASA selected the Ares I crew launch vehicle and the Ares V cargo launch vehicle to provide that transportation. Guiding principles in creating the architecture represented by the Ares vehicles were the maximum use of heritage hardware and legacy knowledge, particularly Space Shuttle assets, and commonality between the Ares vehicles where possible to streamline the hardware development approach and reduce programmatic, technical, and budget risks. The J-2X exemplifies those goals. It was selected by the Exploration Systems Architecture Study (ESAS) as the upper stage propulsion for the Ares I Upper Stage and the Ares V Earth Departure Stage (EDS). The J-2X is an evolved version ofthe historic J-2 engine that successfully powered the second stage of the Saturn I launch vehicle and the second and third stages of the Saturn V launch vehicle. The Constellation architecture, however, requires performance greater than its predecessor. The new architecture calls for larger payloads delivered to the Moon and demands greater loss of mission reliability and numerous other requirements associated with human rating that were not applied to the original J-2. As a result, the J-2X must operate at much higher temperatures, pressures, and flow rates than the heritage J-2, making it one of the highest performing gas generator cycle engines ever built, approaching the efficiency of more complex stage combustion engines. Development is focused on early risk mitigation, component and subassembly test, and engine system test. The development plans include testing engine components, including the subscale injector, main igniter, powerpack assembly (turbopumps, gas generator and associated ducting and structural mounts), full-scale gas generator, valves, and control software with hardware

Testing of Selective Laser Melting Turbomachinery Applicable to Exploration Upper Stage

NASA Technical Reports Server (NTRS)

Calvert, Marty; Turpin, Jason; Nettles, Mindy

2015-01-01

This task is to design, fabricate, and spin test to failure a Ti6-4 hydrogen turbopump impeller that was built using the selective laser melting (SLM) fabrication process (fig. 1). The impeller is sized around upper stage engine requirements. In addition to the spin burst test, material testing will be performed on coupons that are built with the impeller.

Second Stage (S-II) Arrives at Marshall Space Flight Center For Testing

NASA Technical Reports Server (NTRS)

2004-01-01

The business end of a Second Stage (S-II) slowly emerges from the shipping container as workers prepare to transport the Saturn V component to the testing facility at MSFC. The Second Stage (S-II) underwent vibration and engine firing tests. The towering 363-foot Saturn V was a multi-stage, multi-engine launch vehicle standing taller than the Statue of Liberty. Altogether, the Saturn V engines produced as much power as 85 Hoover Dams.

Assembly of 5.5-Meter Diameter Developmental Barrel Segments for the Ares I Upper Stage

NASA Technical Reports Server (NTRS)

Carter, Robert W.

2011-01-01

Full scale assembly welding of Ares I Upper Stage 5.5-Meter diameter cryogenic tank barrel segments has been performed at the Marshall Space Flight Center (MSFC). One full-scale developmental article produced under the Ares 1 Upper Stage project is the Manufacturing Demonstration Article (MDA) Barrel. This presentation will focus on the welded assembly of this barrel section, and associated lessons learned. Among the MDA articles planned on the Ares 1 Program, the Barrel was the first to be completed, primarily because the process of manufacture from piece parts (barrel panels) utilized the most mature friction stir process planned for use on the Ares US program: Conventional fixed pin Friction Stir Welding (FSW). This process is in use on other space launch systems, including the Shuttle s External Tank, the Delta IV common booster core, the Delta II, and the Atlas V rockets. The goals for the MDA Barrel development were several fold: 1) to prove out Marshall Space Flight Center s new Vertical Weld Tool for use in manufacture of cylindrical barrel sections, 2) to serve as a first run for weld qualification to a new weld specification, and 3) to provide a full size cylindrical section for downstream use in precision cleaning and Spray-on Foam Insulation development. The progression leading into the welding of the full size barrel included sub scale panel welding, subscale cylinder welding, a full length confidence weld, and finally, the 3 seamed MDA barrel processing. Lessons learned on this MDA program have been carried forward into the production tooling for the Ares 1 US Program, and in the use of the MSFC VWT in processing other large scale hardware, including two 8.4 meter diameter Shuttle External Tank barrel sections that are currently being used in structural analysis to validate shell buckling models.

Two technicians apply insulation to S-II second stage

NASA Technical Reports Server (NTRS)

1964-01-01

Two technicians apply insulation to the outer surface of the S-II second stage booster for the Saturn V moon rocket. The towering 363-foot Saturn V was a multi-stage, multi-engine launch vehicle standing taller than the Statue of Liberty. Altogether, the Saturn V engines produced as much power as 85 Hoover Dams.

Extended Cancer Education for Longer-Term Survivors in Primary Care for Patients With Stage I-II Breast or Prostate Cancer or Stage I-III Colorectal Cancer

ClinicalTrials.gov

2017-11-15

Stage I Breast Cancer; Stage I Colorectal Cancer AJCC v6 and v7; Stage I Prostate Cancer; Stage IA Breast Cancer; Stage IB Breast Cancer; Stage II Breast Cancer; Stage II Colorectal Cancer AJCC v7; Stage II Prostate Cancer; Stage IIA Breast Cancer; Stage IIA Colorectal Cancer AJCC v7; Stage IIA Prostate Cancer; Stage IIB Breast Cancer; Stage IIB Colorectal Cancer AJCC v7; Stage IIB Prostate Cancer; Stage IIC Colorectal Cancer AJCC v7; Stage III Colorectal Cancer AJCC v7; Stage IIIA Colorectal Cancer AJCC v7; Stage IIIB Colorectal Cancer AJCC v7; Stage IIIC Colorectal Cancer AJCC v7

FDG-PET/CT Limited to the Thorax and Upper Abdomen for Staging and Management of Lung Cancer.

PubMed

Arens, Anne I J; Postema, Jan W A; Schreurs, Wendy M J; Lafeber, Albert; Hendrickx, Baudewijn W; Oyen, Wim J G; Vogel, Wouter V

2016-01-01

This study evaluates the diagnostic accuracy of [F-18]-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) of the chest/upper abdomen compared to the generally performed scan from head to upper thighs, for staging and management of (suspected) lung cancer in patients with no history of malignancy or complaints outside the thorax. FDG-PET/CT scans of 1059 patients with suspected or recently proven lung cancer, with no history of malignancy or complaints outside the thorax, were analysed in a retrospective multi-centre trial. Suspect FDG-avid lesions in the chest and upper abdomen, the head and neck area above the shoulder line and in the abdomen and pelvis below the caudal tip of the liver were noted. The impact of lesions detected in the head and neck area and abdomen and pelvis on additional diagnostic procedures, staging and treatment decisions was evaluated. The head and neck area revealed additional suspect lesions in 7.2%, and the abdomen and pelvis in 15.8% of patients. Imaging of the head and neck area and the abdomen and pelvic area showed additional lesions in 19.5%, inducing additional diagnostic procedures in 7.8%. This resulted in discovery of additional lesions considered malignant in 10.7%, changing patient management for lung cancer in 1.2%. In (suspected) lung cancer, PET/CT limited to the chest and upper abdomen resulted in correct staging in 98.7% of patients, which led to the identical management as full field of view PET in 98.8% of patients. High value of FDG-PET/CT for staging and correct patient management is already achieved with chest and upper abdomen. Findings in head and neck area and abdomen and pelvis generally induce investigations with limited or no impact on staging and treatment of NSCLC, and can be interpreted accordingly.

Dinoflagellates: Fossil motile-stage tests from the upper cretaceous of the Northern New Jersey coastal plain

USGS Publications Warehouse

May, F.E.

1976-01-01

Fossil dinoflagellate tests have been considered to represent encysted, nonmotile stages. The discovery of flagellar porelike structures and probable trichocyst pores in the Upper Cretaceous genus Dinogymnium suggests that motile stage tests are also preserved as acid-resistant, organic-walled microfossils.

Characterization of the 2012-044C BRIZ-M Upper Stage Breakup

NASA Astrophysics Data System (ADS)

Matney, M. J.; Hamilton, J.; Horstman, M.; Papanyan, V.

2013-08-01

On 6 August 2012, Russia launched two commercial satellites aboard a Proton rocket, and attempted to place them in geosynchronous orbit using a Briz-M upper stage (2012-044C, SSN 38746). Unfortunately, the upper stage failed early in its burn and was left stranded in an elliptical orbit with a perigee in low Earth orbit (LEO). Because the stage failed with much of its fuel on board, it was deemed a significant breakup risk. These fears were confirmed when it broke up 16 October, creating a large cloud of debris with perigees below that of the International Space Station. The debris cloud was tracked by the U.S. Space Surveillance Network (SSN), which can reliably detect and track objects down to about 10 cm in size. Because of the unusual geometry of the breakup, there was an opportunity for the NASA Orbital Debris Program Office to use specialized radar assets to characterize the extent of the debris cloud in sizes smaller than the standard debris tracked by the SSN. This paper describes the observation campaign to measure the small particle distributions of this cloud and presents the results of the data analysis. We shall compare the data to the modelled size distribution, number, and shape of the cloud, and what implications this may have for future breakup debris models. We shall conclude the paper with a discussion about how this measurement process can be improved for future breakups.

Characterization of the 2012-044C Briz-M Upper Stage Breakup

NASA Technical Reports Server (NTRS)

Matney, M. J.; Hamilton, J.; Horstman, M.; Papanyan, V.

2013-01-01

On 6 August, 2012, Russia launched two commercial satellites aboard a Proton rocket, and attempted to place them in geosynchronous orbit using a Briz-M upper stage (2012-044C, SSN 38746). Unfortunately, the upper stage failed early in its burn and was left stranded in an elliptical orbit with a perigee in low Earth orbit (LEO). Because the stage failed with much of its fuel on board, it was deemed a significant breakup risk. These fears were confirmed when it broke up 16 October, creating a large cloud of debris with perigees below that of the International Space Station. The debris cloud was tracked by the US Space Surveillance Network (SSN), which can reliably detect and track objects down to about 10 cm in size. Because of the unusual geometry of the breakup, there was an opportunity for NASA Orbital Debris Program Office to use specialized radar assets to characterize the extent of the debris cloud in sizes smaller than the standard debris tracked by the SSN. This paper will describe the observation campaign to measure the small particle distributions of this cloud, and presents the results of the analysis of the data. We shall compare the data to the modelled size distribution, number, and shape of the cloud, and what implications this may have for future breakup debris models. We shall conclude the paper with a discussion how this measurement process can be improved for future breakups.

Characterization of the 2012-044c Briz-M Upper Stage Breakup

NASA Technical Reports Server (NTRS)

Matney, M. J.; Hamilton, Joseph; Papanyan, Valen

2013-01-01

On 6 August, 2012, Russia launched two commercial satellites aboard a Proton rocket, and attempted to place them in geosynchronous orbit using a Briz-M upper stage (2012-044C, SSN 38746). Unfortunately, the upper stage failed early in its burn and was left stranded in an elliptical orbit with a perigee in low Earth orbit (LEO). Because the stage failed with much of its fuel on board, it was deemed a significant breakup risk. These fears were confirmed when it broke up 16 October, creating a large cloud of debris with perigees below that of the International Space Station. The debris cloud was tracked by the US Space Surveillance Network (SSN), which can reliably detect and track objects down to about 10 cm in size. Because of the unusual geometry of the breakup, there was an opportunity for NASA Orbital Debris Program Office to request radar assets to characterize the extent of the debris cloud in sizes smaller than the standard debris tracked by the SSN. This paper will describe the observation campaign to measure the small particle distributions of this cloud, and presents the results of the analysis of the data. We shall compare the data to the modelled size distribution, number, and shape of the cloud, and what implications this may have for future breakup debris models. We shall conclude the paper with a discussion how this measurement process can be improved for future breakups.

Administration of adjuvant chemotherapy for stage II-III colon cancer patients: An European population-based study.

PubMed

Babaei, Masoud; Balavarca, Yesilda; Jansen, Lina; Lemmens, Valery; van Erning, Felice N; van Eycken, Liesbet; Vaes, Evelien; Sjövall, Annika; Glimelius, Bengt; Ulrich, Cornelia M; Schrotz-King, Petra; Brenner, Hermann

2018-04-01

The advantage of adjuvant chemotherapy (ACT) for treating Stage III colon cancer patients is well established and widely accepted. However, many patients with Stage III colon cancer do not receive ACT. Moreover, there are controversies around the effectiveness of ACT for Stage II patients. We investigated the administration of ACT and its association with overall survival in resected Stage II (overall and stratified by low-/high-risk) and Stage III colon cancer patients in three European countries including The Netherlands (2009-2014), Belgium (2009-2013) and Sweden (2009-2014). Hazard ratios (HR) for death were obtained by Cox regression models adjusted for potential confounders. A total of 60244 resected colon cancer patients with pathological Stages II and III were analyzed. A small proportion (range 9-24%) of Stage II and over half (range 55-68%) of Stage III patients received ACT. Administration of ACT in Stages II and III tumors decreased with higher age of patients. Administration of ACT was significantly associated with higher overall survival in high-risk Stage II patients (in The Netherlands (HR; 95%CI = 0.82 (0.67-0.99), Belgium (0.73; 0.59-0.90) and Sweden (0.58; 0.44-0.75)), and in Stage III patients (in The Netherlands (0.47; 0.43-0.50), Belgium (0.46; 0.41-0.50) and Sweden (0.48; 0.43-0.54)). In Stage III, results were consistent across subgroups including elderly patients. Our results show an association of ACT with higher survival among Stage III and high-risk Stage II colon cancer patients. Further investigations are needed on the selection criteria of Stages II and III colon cancer patients for ACT. © 2017 UICC.

Oral Sulforaphane increases Phase II antioxidant enzymes in the human upper airway

PubMed Central

Riedl, Marc A.; Saxon, Andrew; Diaz-Sanchez, David

2009-01-01

Background Cellular oxidative stress is an important factor in asthma and is thought to be the principle mechanism by which oxidant pollutants such as ozone and particulates mediate their pro-inflammatory effects. Endogenous Phase II enzymes abrogate oxidative stress through the scavenging of reactive oxygen species and metabolism of reactive chemicals. Objective We conducted a placebo-controlled dose escalation trial to investigate the in vivo effects of sulforaphane, a naturally occurring potent inducer of Phase II enzymes, on the expression of glutathione-s-transferase M1 (GSTM1), glutathione-s-transferase P1 (GSTP1), NADPH quinone oxidoreductase (NQO1), and hemoxygenase-1 (HO-1) in the upper airway of human subjects. Methods Study subjects consumed oral sulforaphane doses contained in a standardized broccoli sprout homogenate (BSH). RNA expression for selected Phase II enzymes was measured in nasal lavage cells by RT-PCR before and after sulforaphane dosing. Results All subjects tolerated oral sulforaphane dosing without significant adverse events. Increased Phase II enzyme expression in nasal lavage cells occurred in a dose-dependent manner with maximal enzyme induction observed at the highest dose of 200 grams broccoli sprouts prepared as BSH. Significant increases were seen in all sentinel Phase II enzymes RNA expression compared to baseline. Phase II enzyme induction was not seen with ingestion of non-sulforaphane containing alfalfa sprouts. Conclusion Oral sulforaphane safely and effectively induces mucosal Phase II enzyme expression in the upper airway of human subjects. This study demonstrates the potential of antioxidant Phase II enzymes induction in the human airway as a strategy to reduce the inflammatory effects of oxidative stress. Clinical Implications This study demonstrates the potential of enhancement of Phase II enzyme expression as a novel therapeutic strategy for oxidant induced airway disease. Capsule Summary A placebo-controlled dose

Growing a Training System and Culture for the Ares I Upper Stage Project

NASA Technical Reports Server (NTRS)

Scott, David W.

2009-01-01

In roughly two years time, Marshall Space Flight Center s (MSFC) Mission Operations Laboratory (MOL) has incubated a personnel training and certification program for about 1000 learners and multiple phases of the Ares I Upper Stage (US) project. Previous MOL-developed training programs focused on about 100 learners with a focus on operations, and had enough full-time training staff to develop courseware and provide training administration. This paper discusses 1) the basics of MOL's training philosophy, 2) how creation of a broad, structured training program unfolded as feedback from more narrowly defined tasks, 3) how training philosophy, development methods, and administration are being simplified and tailored so that many Upper Stage organizations can "grow their own" training yet maintain consistency, accountability, and traceability across the project, 4) interfacing with the production contractor's training system and staff, and 5) reaping training value from existing materials and events.

Shuttle/IUS performance for planetary missions. [Interim Upper Stage

NASA Technical Reports Server (NTRS)

Cork, M. J.; Driver, J. M.; Wright, J. L.

1975-01-01

Potential requirements for planetary missions in the 1980s, capabilities of the Interim Upper Stage (IUS) candidates to perform those missions, and Shuttle/IUS mission profile options for performance enhancement are examined. The most demanding planetary missions are the Pioneer Saturn/Uranus/Titan Probe and the Mariner-class orbiters of Mercury, Jupiter, and Saturn. Options available to designers of these missions will depend on the specific IUS selected for development and the programmatic phasing of the IUS and the NASA Tug. Use of Shuttle elliptic orbits as initial conditions for IUS ignition offers significant performance improvements; specific values are mission dependent.

Space Launch System Upper Stage Technology Assessment

NASA Technical Reports Server (NTRS)

Holladay, Jon; Hampton, Bryan; Monk, Timothy

2014-01-01

The Space Launch System (SLS) is envisioned as a heavy-lift vehicle that will provide the foundation for future beyond low-Earth orbit (LEO) exploration missions. Previous studies have been performed to determine the optimal configuration for the SLS and the applicability of commercial off-the-shelf in-space stages for Earth departure. Currently NASA is analyzing the concept of a Dual Use Upper Stage (DUUS) that will provide LEO insertion and Earth departure burns. This paper will explore candidate in-space stages based on the DUUS design for a wide range of beyond LEO missions. Mission payloads will range from small robotic systems up to human systems with deep space habitats and landers. Mission destinations will include cislunar space, Mars, Jupiter, and Saturn. Given these wide-ranging mission objectives, a vehicle-sizing tool has been developed to determine the size of an Earth departure stage based on the mission objectives. The tool calculates masses for all the major subsystems of the vehicle including propellant loads, avionics, power, engines, main propulsion system components, tanks, pressurization system and gases, primary structural elements, and secondary structural elements. The tool uses an iterative sizing algorithm to determine the resulting mass of the stage. Any input into one of the subsystem sizing routines or the mission parameters can be treated as a parametric sweep or as a distribution for use in Monte Carlo analysis. Taking these factors together allows for multi-variable, coupled analysis runs. To increase confidence in the tool, the results have been verified against two point-of-departure designs of the DUUS. The tool has also been verified against Apollo moon mission elements and other manned space systems. This paper will focus on trading key propulsion technologies including chemical, Nuclear Thermal Propulsion (NTP), and Solar Electric Propulsion (SEP). All of the key performance inputs and relationships will be presented and

Glacial stages and post-glacial environmental evolution in the Upper Garonne valley, Central Pyrenees.

PubMed

Fernandes, M; Oliva, M; Palma, P; Ruiz-Fernández, J; Lopes, L

2017-04-15

The maximum glacial extent in the Central Pyrenees during the Last Glaciation is known to have occurred before the global Last Glacial Maximum, but the succession of cold events afterwards and their impact on the landscape are still relatively unknown. This study focuses on the environmental evolution in the upper valley of the Garonne River since the Last Glaciation. Geomorphological mapping allows analysis of the spatial distribution of inherited and current processes and landforms in the study area. The distribution of glacial records (moraines, till, erratic boulders, glacial thresholds) suggests the existence of four glacial stages, from the maximum expansion to the end of the glaciation. GIS modeling allows quantification of the Equilibrium Line Altitude, extent, thickness and volume of ice in each glacial stage. During the first stage, the Garonne glacier reached 460m in the Loures-Barousse-Barbazan basin, where it formed a piedmont glacier 88km from the head and extended over 960km 2 . At a second stage of glacier stabilization during the deglaciation process, the valley glaciers were 12-23km from the head until elevations of 1000-1850m, covering an area of 157km 2 . Glaciers during stage three remained isolated in the upper parts of the valley, at heights of 2050-2200m and 2.6-4.5km from the head, with a glacial surface of 16km 2 . In stage four, cirque glaciers were formed between 2260m and 2590m, with a length of 0.4-2km and a glacial area of 5.7km 2 . Also, the wide range of periglacial, slope, nival and alluvial landforms existing in the formerly glaciated environments allows reconstruction of the post-glacial environmental dynamics in the upper Garonne basin. Today, the highest lands are organized following three elevation belts: subnival (1500-1900m), nival (1900-2300m) and periglacial/cryonival (2300-2800m). Copyright © 2017 Elsevier B.V. All rights reserved.

J-2X Upper Stage Engine: Hardware and Testing 2009

NASA Technical Reports Server (NTRS)

Buzzell, James C.

2009-01-01

Mission: Common upper stage engine for Ares I and Ares V. Challenge: Use proven technology from Saturn X-33, RS-68 to develop the highest Isp GG cycle engine in history for 2 missions in record time . Key Features: LOX/LH2 GG cycle, series turbines (2), HIP-bonded MCC, pneumatic ball-sector valves, on-board engine controller, tube-wall regen nozzle/large passively-cooled nozzle extension, TEG boost/cooling . Development Philosophy: proven hardware, aggressive schedule, early risk reduction, requirements-driven.

Analytical Approach for Estimating Preliminary Mass of ARES I Crew Launch Vehicle Upper Stage Structural Components

NASA Technical Reports Server (NTRS)

Aggarwal, Pravin

2007-01-01

In January 2004, President Bush gave the National Aeronautics and Space Administration (NASA) a vision for Space Exploration by setting our sight on a bold new path to go back to the Moon, then to Mars and beyond. In response to this vision, NASA started the Constellation Program, which is a new exploration launch vehicle program. The primary mission for the Constellation Program is to carry out a series of human expeditions ranging from Low Earth Orbit to the surface of Mars and beyond for the purposes of conducting human exploration of space, as specified by the Vision for Space Exploration (VSE). The intent is that the information and technology developed by this program will provide the foundation for broader exploration activities as our operational experience grows. The ARES I Crew Launch Vehicle (CLV) has been designated as the launch vehicle that will be developed as a "first step" to facilitate the aforementioned human expeditions. The CLV Project is broken into four major elements: First Stage, Upper Stage Engine, Upper Stage (US), and the Crew Exploration Vehicle (CEV). NASA's Marshall Space Flight Center (MSFC) is responsible for the design of the CLV and has the prime responsibility to design the upper stage of the vehicle. The US is the second propulsive stage of the CLV and provides CEV insertion into low Earth orbit (LEO) after separation from the First Stage of the Crew Launch Vehicle. The fully integrated Upper Stage is a mix of modified existing heritage hardware (J-2X Engine) and new development (primary structure, subsystems, and avionics). The Upper Stage assembly is a structurally stabilized cylindrical structure, which is powered by a single J-2X engine which is developed as a separate Element of the CLV. The primary structure includes the load bearing liquid hydrogen (LH2) and liquid oxygen (LOX) propellant tanks, a Forward Skirt, the Intertank structure, the Aft Skirt and the Thrust Structure. A Systems Tunnel, which carries fluid and

Second Stage (S-II) Plays Key Role in Apollo missions

NASA Technical Reports Server (NTRS)

1970-01-01

This photograph of the Saturn V Second Stage (S-II) clearly shows the cluster of five powerful J-2 engines needed to boost the Apollo spacecraft into earth orbit following first stage separation. The towering 363-foot Saturn V was a multi-stage, multi-engine launch vehicle standing taller than the Statue of Liberty. Altogether, the Saturn V engines produced as much power as 85 Hoover Dams.

Upper Stage Tank Thermodynamic Modeling Using SINDA/FLUINT

NASA Technical Reports Server (NTRS)

Schallhorn, Paul; Campbell, D. Michael; Chase, Sukhdeep; Piquero, Jorge; Fortenberry, Cindy; Li, Xiaoyi; Grob, Lisa

2006-01-01

Modeling to predict the condition of cryogenic propellants in an upper stage of a launch vehicle is necessary for mission planning and successful execution. Traditionally, this effort was performed using custom, in-house proprietary codes, limiting accessibility and application. Phenomena responsible for influencing the thermodynamic state of the propellant have been characterized as distinct events whose sequence defines a mission. These events include thermal stratification, passive thermal control roll (rotation), slosh, and engine firing. This paper demonstrates the use of an off the shelf, commercially available, thermal/fluid-network code to predict the thermodynamic state of propellant during the coast phase between engine firings, i.e. the first three of the above identified events. Results of this effort will also be presented.

Inertial upper stage - Upgrading a stopgap proves difficult

NASA Astrophysics Data System (ADS)

Geddes, J. P.

The technological and project management difficulties associated with the Inertial Upper Stage's (IUS) development and performance to date are assessed, with a view to future prospects for this system. The IUS was designed for use both on the interim Titan 34D booster and the Space Shuttle Orbiter. The IUS malfunctions and cost overruns reported are substantially due to the system's reliance on novel propulsion and avionics technology. Its two solid rocket motors, which were selected on the basis of their inherent safety for use on the Space Shuttle, have the longest burn time extant. A three-dimensional carbon/carbon nozzle throat had to be developed to sustain this long burn, as were lightweight composite wound cases and shirts, insulation, igniters, and electromechanical thrust vector control.

Primary radiation therapy for medically inoperable patients with endometrial carcinoma--stages I-II.

PubMed

Varia, M; Rosenman, J; Halle, J; Walton, L; Currie, J; Fowler, W

1987-01-01

Surgery with or without adjuvant radiation is the established method of treating patients with Stage I and II adenocarcinoma of the endometrium. However, patients who are poor operative risks must be treated with radiation therapy only. We report on 73 such patients treated at the University of North Carolina between 1969 and 1980. All patients had an adenocarcinoma of the endometrium; 41 were FIGO Stage I, 32 Stage II. The minimum follow-up period was 4 years. Life table analysis shows a disease-free survival of 72% at 3 years and 57% at 5 years for Stage I patients. There was a strong correlation between histologic tumor grade and survival in these patients; the 5-year survival for grade 1 was 72%, for grade 2 59%, and for grade 3 31%. The difference between G1 and G3 is significant at the p = .045 level. Coexisting medical conditions were responsible for 12 deaths; almost as many as the 16 cancer-related deaths. Stage II patients have an actuarial disease-free survival of 36% at 3 years and 26% at 5 years, significantly worse than Stage I patients (p = .029 at 3 years). Failures were seen in 16/41 (39%) Stage I and 19/32 (59%) Stage II patients; 29/35 (83%) of these recurrences had component of local/pelvic failure and 15/35 (43%) of the recurrences were local/pelvic only. Specific suggestions on how to improve local therapy for these patients are presented.

Curcumin and Cholecalciferol in Treating Patients With Previously Untreated Stage 0-II Chronic Lymphocytic Leukemia or Small Lymphocytic Lymphoma

ClinicalTrials.gov

2018-01-26

Contiguous Stage II Small Lymphocytic Lymphoma; Noncontiguous Stage II Small Lymphocytic Lymphoma; Stage 0 Chronic Lymphocytic Leukemia; Stage I Chronic Lymphocytic Leukemia; Stage I Small Lymphocytic Lymphoma; Stage II Chronic Lymphocytic Leukemia

A Supersonic/Hypersonic Aerodynamic Investigation of the Saturn 1B/Apollo Upper Stage

NASA Technical Reports Server (NTRS)

1966-01-01

The static stability and axial force characteristics of an upper stage Saturn 1B/Apollo model were investigated in a series of wind tunnel tests at Mach numbers between 1. 93 and 8. 05. This report presents and analyzes the results of these small-scale studies. Test procedures and models are described, and consideration of boundary layer characteristics and violated modeling rules yields an assessment of the validity of the data. Four basic models provided evaluation of the basic launch vehicle characteristics, as well as the effects of two modes of mission abort and jettison of the launch escape system. The launch configuration experienced sudden, strong changes in stability derivatives and axial force coefficients near Mach 5. No similar changes were observed on the other configurations. Effects of Reynolds number, Mach number and boundary layer trips were obtained for each shape. The faired curves are believed to be valid for full-scale flight of the Saturn 1B/Apollo upper stage.

Operations analysis (study 2.1). Contingency analysis. [of failure modes anticipated during space shuttle upper stage planning

NASA Technical Reports Server (NTRS)

1974-01-01

Future operational concepts for the space transportation system were studied in terms of space shuttle upper stage failure contingencies possible during deployment, retrieval, or space servicing of automated satellite programs. Problems anticipated during mission planning were isolated using a modified 'fault tree' technique, normally used in safety analyses. A comprehensive space servicing hazard analysis is presented which classifies possible failure modes under the catagories of catastrophic collision, failure to rendezvous and dock, servicing failure, and failure to undock. The failure contingencies defined are to be taken into account during design of the upper stage.

LOX/LH2 propulsion system for launch vehicle upper stage, test results

NASA Technical Reports Server (NTRS)

Ikeda, T.; Imachi, U.; Yuzawa, Y.; Kondo, Y.; Miyoshi, K.; Higashino, K.

1984-01-01

The test results of small LOX/LH2 engines for two propulsion systems, a pump fed system and a pressure fed system are reported. The pump fed system has the advantages of higher performances and higher mass fraction. The pressure fed system has the advantages of higher reliability and relative simplicity. Adoption of these cryogenic propulsion systems for upper stage of launch vehicle increases the payload capability with low cost. The 1,000 kg thrust class engine was selected for this cryogenic stage. A thrust chamber assembly for the pressure fed propulsion system was tested. It is indicated that it has good performance to meet system requirements.

Cluster II quartet take the stage together

NASA Astrophysics Data System (ADS)

1999-11-01

This is the only occasion on which all four of ESA's Cluster II spacecraft will be on display together in Europe. Four Spacecraft, One Mission The unique event takes place near the end of the lengthy assembly and test programme, during which each individual spacecraft is being assembled in sequence, one after the other. Two have already completed their assembly and systems testing and are about to be stored in special containers at IABG prior to shipment to the Baikonur launch site in Kazakhstan next spring. In the case of the other two, flight models 5 and 8, installation of the science payloads has finished, but their exhaustive series of environmental tests at IABG have yet to begin. Following delivery to the launch site next April, the satellites will be launched in pairs in June and July 2000. Two Soyuz rockets, each with a newly designed Fregat upper stage, are being provided by the Russian-French Starsem company. This will be the first time ESA satellites have been launched from the former Soviet Union. Cluster II is a replacement for the original Cluster mission, which was lost during the maiden launch of Ariane 5 in June 1996. ESA, given the mission's importance in its overall strategy in the area of the Sun-Earth connection, decided to rebuild this unique project. ESA member states supported that proposal. On 3 April 1997, the Agency's Science Programme Committee agreed. Cluster II was born. European Teamwork Scientific institutions and industrial enterprises in almost all the 14 ESA member states and the United States are taking part in the Cluster II project. Construction of the eight Cluster / Cluster II spacecraft has been a major undertaking for European industry. Built into each 1200 kg satellite are six propellant tanks, two pressure tanks, eight thrusters, 80 metres of pipework, about 5 km of wiring, 380 connectors and more than 14 000 electrical contacts. All the spacecraft were assembled in the giant clean room at the Friedrichshafen plant of

Assessment and Verification of SLS Block 1-B Exploration Upper Stage State and Stage Disposal Performance

NASA Technical Reports Server (NTRS)

Patrick, Sean; Oliver, Emerson

2018-01-01

One of the SLS Navigation System's key performance requirements is a constraint on the payload system's delta-v allocation to correct for insertion errors due to vehicle state uncertainty at payload separation. The SLS navigation team has developed a Delta-Delta-V analysis approach to assess the effect on trajectory correction maneuver (TCM) design needed to correct for navigation errors. This approach differs from traditional covariance analysis based methods and makes no assumptions with regard to the propagation of the state dynamics. This allows for consideration of non-linearity in the propagation of state uncertainties. The Delta-Delta-V analysis approach re-optimizes perturbed SLS mission trajectories by varying key mission states in accordance with an assumed state error. The state error is developed from detailed vehicle 6-DOF Monte Carlo analysis or generated using covariance analysis. These perturbed trajectories are compared to a nominal trajectory to determine necessary TCM design. To implement this analysis approach, a tool set was developed which combines the functionality of a 3-DOF trajectory optimization tool, Copernicus, and a detailed 6-DOF vehicle simulation tool, Marshall Aerospace Vehicle Representation in C (MAVERIC). In addition to delta-v allocation constraints on SLS navigation performance, SLS mission requirement dictate successful upper stage disposal. Due to engine and propellant constraints, the SLS Exploration Upper Stage (EUS) must dispose into heliocentric space by means of a lunar fly-by maneuver. As with payload delta-v allocation, upper stage disposal maneuvers must place the EUS on a trajectory that maximizes the probability of achieving a heliocentric orbit post Lunar fly-by considering all sources of vehicle state uncertainty prior to the maneuver. To ensure disposal, the SLS navigation team has developed an analysis approach to derive optimal disposal guidance targets. This approach maximizes the state error covariance prior

78 FR 28776 - Approval and Promulgation of Implementation Plans; Kentucky; Stage II Requirements for Enterprise...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-16

... the December 12, 2006, EPA policy memorandum from Stephen D. Page, entitled ``Removal of Stage II... memorandum from Stephen D. Page entitled, ``Removal of Stage II Vapor Recovery in Situations Where Widespread...

Testing for the J-2X Upper Stage Engine

NASA Technical Reports Server (NTRS)

Buzzell, James C.

2010-01-01

NASA selected the J-2X Upper Stage Engine in 2006 to power the upper stages of the Ares I crew launch vehicle and the Ares V cargo launch vehicle. Based on the proven Saturn J-2 engine, this new engine will provide 294,000 pounds of thrust and a specific impulse of 448 seconds, making it the most efficient gas generator cycle engine in history. The engine's guiding philosophy emerged from the Exploration Systems Architecture Study (ESAS) in 2005. Goals established then called for vehicles and components based, where feasible, on proven hardware from the Space Shuttle, commercial, and other programs, to perform the mission and provide an order of magnitude greater safety. Since that time, the team has made unprecedented progress. Ahead of the other elements of the Constellation Program architecture, the team has progressed through System Requirements Review (SRR), System Design Review (SDR), Preliminary Design Review (PDR), and Critical Design Review (CDR). As of February 2010, more than 100,000 development engine parts have been ordered and more than 18,000 delivered. Approximately 1,300 of more than 1,600 engine drawings were released for manufacturing. A major factor in the J-2X development approach to this point is testing operations of heritage J-2 engine hardware and new J-2X components to understand heritage performance, validate computer modeling of development components, mitigate risk early in development, and inform design trades. This testing has been performed both by NASA and its J-2X prime contractor, Pratt & Whitney Rocketdyne (PWR). This body of work increases the likelihood of success as the team prepares for testing the J-2X powerpack and first development engine in calendar 2011. This paper will provide highlights of J-2X testing operations, engine test facilities, development hardware, and plans.

Infusing Training into the Documentation and Culture of Ares I Upper Stage Design and Manufacturing

NASA Technical Reports Server (NTRS)

Scott, David W.

2009-01-01

In roughly two years time, Marshall Space Flight Center's (MSFC) Mission Operations Laboratory (MOL) has incubated a personnel training and certification program for about 1000 learners and multiple phases of the Ares I Upper Stage (US) project. Previous MOL-developed training programs focused on about 100 learners with a focus on operations, and had enough full-time training staff to develop courseware and provide training administration. This paper discusses 1) how creation of a broad, structured training program unfolded as feedback from more narrowly defined tasks, 2) how training philosophy, development methods, and administration are being simplified and tailored so that many Upper Stage organizations can grow their own training yet maintain consistency, accountability, and traceability across the project, and 3) possibilities for interfacing with the production contractor's training system and staff.

Taming Liquid Hydrogen: The Centaur Upper Stage Rocket, 1958-2002

NASA Technical Reports Server (NTRS)

Dawson, Virginia P.; Bowles, Mark D.

2004-01-01

During its maiden voyage in May 1962, a Centaur upper stage rocket, mated to an Atlas booster, exploded 54 seconds after launch, engulfing the rocket in a huge fireball. Investigation revealed that Centaur's light, stainless-steel tank had split open, spilling its liquid-hydrogen fuel down its sides, where the flame of the rocket exhaust immediately ignited it. Coming less than a year after President Kennedy had made landing human beings on the Moon a national priority, the loss of Centaur was regarded as a serious setback for the National Aeronautics and Space Administration (NASA). During the failure investigation, Homer Newell, Director of Space Sciences, ruefully declared: "Taming liquid hydrogen to the point where expensive operational space missions can be committed to it has turned out to be more difficult than anyone supposed at the outset." After this failure, Centaur critics, led by Wernher von Braun, mounted a campaign to cancel the program. In addition to the unknowns associated with liquid hydrogen, he objected to the unusual design of Centaur. Like the Atlas rocket, Centaur depended on pressure to keep its paper-thin, stainless-steel shell from collapsing. It was literally inflated with its propellants like a football or balloon and needed no internal structure to give it added strength and stability. The so-called "pressure-stabilized structure" of Centaur, coupled with the light weight of its high- energy cryogenic propellants, made Centaur lighter and more powerful than upper stages that used conventional fuel. But, the critics argued, it would never become the reliable rocket that the United States needed.

Upper thermal tolerances of early life stages of freshwater mussels

USGS Publications Warehouse

Pandolfo, Tamara J.; Cope, W. Gregory; Arellano, Consuelo; Bringolf, Robert B.; Barnhart, M. Christopher; Hammer, E

2010-01-01

Freshwater mussels (order Unioniformes) fulfill an essential role in benthic aquatic communities, but also are among the most sensitive and rapidly declining faunal groups in North America. Rising water temperatures, caused by global climate change, industrial discharges, drought, or land development, could further challenge imperiled unionid communities. The aim of our study was to determine the upper thermal tolerances of the larval (glochidia) and juvenile life stages of freshwater mussels. Glochidia of 8 species of mussels were tested: Lampsilis siliquoidea, Potamilus alatus, Ligumia recta, Ellipsaria lineolata,Lasmigona complanata, Megalonaias nervosa, Alasmidonta varicosa, and Villosa delumbis. Seven of these species also were tested as juveniles. Survival trends were monitored while mussels held at 3 acclimation temperatures (17, 22, and 27°C) were exposed to a range of common and extreme water temperatures (20–42°C) in standard acute laboratory tests. The average median lethal temperature (LT50) among species in 24-h tests with glochidia was 31.6°C and ranged from 21.4 to 42.7°C. The mean LT50 in 96-h juvenile tests was 34.7°C and ranged from 32.5 to 38.8°C. Based on comparisons of LT50s, thermal tolerances differed among species for glochidia, but not for juveniles. Acclimation temperature did not affect thermal tolerance for either life stage. Our results indicate that freshwater mussels already might be living close to their upper thermal tolerances in some systems and, thus, might be at risk from rising environmental temperatures.

Lifetime Estimation of the Upper Stage of GSAT-14 in Geostationary Transfer Orbit.

PubMed

Jeyakodi David, Jim Fletcher; Sharma, Ram Krishan

2014-01-01

The combination of atmospheric drag and lunar and solar perturbations in addition to Earth's oblateness influences the orbital lifetime of an upper stage in geostationary transfer orbit (GTO). These high eccentric orbits undergo fluctuations in both perturbations and velocity and are very sensitive to the initial conditions. The main objective of this paper is to predict the reentry time of the upper stage of the Indian geosynchronous satellite launch vehicle, GSLV-D5, which inserted the satellite GSAT-14 into a GTO on January 05, 2014, with mean perigee and apogee altitudes of 170 km and 35975 km. Four intervals of near linear variation of the mean apogee altitude observed were used in predicting the orbital lifetime. For these four intervals, optimal values of the initial osculating eccentricity and ballistic coefficient for matching the mean apogee altitudes were estimated with the response surface methodology using a genetic algorithm. It was found that the orbital lifetime from these four time spans was between 144 and 148 days.

Lifetime Estimation of the Upper Stage of GSAT-14 in Geostationary Transfer Orbit

PubMed Central

Jeyakodi David, Jim Fletcher; Sharma, Ram Krishan

2014-01-01

The combination of atmospheric drag and lunar and solar perturbations in addition to Earth's oblateness influences the orbital lifetime of an upper stage in geostationary transfer orbit (GTO). These high eccentric orbits undergo fluctuations in both perturbations and velocity and are very sensitive to the initial conditions. The main objective of this paper is to predict the reentry time of the upper stage of the Indian geosynchronous satellite launch vehicle, GSLV-D5, which inserted the satellite GSAT-14 into a GTO on January 05, 2014, with mean perigee and apogee altitudes of 170 km and 35975 km. Four intervals of near linear variation of the mean apogee altitude observed were used in predicting the orbital lifetime. For these four intervals, optimal values of the initial osculating eccentricity and ballistic coefficient for matching the mean apogee altitudes were estimated with the response surface methodology using a genetic algorithm. It was found that the orbital lifetime from these four time spans was between 144 and 148 days. PMID:27437491

A modified varying-stage adaptive phase II/III clinical trial design.

PubMed

Dong, Gaohong; Vandemeulebroecke, Marc

2016-07-01

Conventionally, adaptive phase II/III clinical trials are carried out with a strict two-stage design. Recently, a varying-stage adaptive phase II/III clinical trial design has been developed. In this design, following the first stage, an intermediate stage can be adaptively added to obtain more data, so that a more informative decision can be made. Therefore, the number of further investigational stages is determined based upon data accumulated to the interim analysis. This design considers two plausible study endpoints, with one of them initially designated as the primary endpoint. Based on interim results, another endpoint can be switched as the primary endpoint. However, in many therapeutic areas, the primary study endpoint is well established. Therefore, we modify this design to consider one study endpoint only so that it may be more readily applicable in real clinical trial designs. Our simulations show that, the same as the original design, this modified design controls the Type I error rate, and the design parameters such as the threshold probability for the two-stage setting and the alpha allocation ratio in the two-stage setting versus the three-stage setting have a great impact on the design characteristics. However, this modified design requires a larger sample size for the initial stage, and the probability of futility becomes much higher when the threshold probability for the two-stage setting gets smaller. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Extracorporeal Membrane Oxygenation Outcomes After the Comprehensive Stage II Procedure in Patients With Single Ventricles.

PubMed

Gomez, Daniel; Duffy, Vicky; Hersey, Diane; Backes, Carl; Rycus, Peter; McConnell, Patrick; Voss, Jordan; Galantowicz, Mark; Cua, Clifford L

2017-01-01

Outcomes for extracorporeal membrane oxygenation (ECMO) have been described for patients with single ventricle physiology (SVP) undergoing cavopulmonary connection (Glenn procedure). An alternative surgical pathway for patients with SVP consists of an initial hybrid procedure followed by a comprehensive Stage II procedure. No data exist describing the outcomes of patients requiring ECMO after the comprehensive Stage II procedure. The goal of this study is to describe the outcomes for patients who required ECMO after the comprehensive Stage II procedure. Data from the Extracorporeal Life Support Organization (ELSO) registry from 2001 to 2015 for children undergoing the comprehensive Stage II procedure older than 3 months of age were retrospectively analyzed. Demographics and ECMO characteristics were recorded. A total of six children required ECMO support after the comprehensive Stage II procedure (2 males, 4 females). Four patients had the diagnosis of hypoplastic left heart syndrome and two patients had the diagnosis of an unbalanced atrioventricular septal defect. Bypass time was 242.8 ± 110.9 min and cross-clamp time was 91.2 ± 46.2 min for the surgical procedure. Weight was 5.8 ± 1.3 kg and age was 150.2 + 37.9 days at time of ECMO. ECMO duration was 276.0 ± 218.1 h. Complications during the ECMO run included hemorrhage in four patients (67%), renal dysfunction in two patients (33%), and neurologic injury in two patients (33%). Four patients (67%) were discharged alive after ECMO decannulation. Despite being a much more extensive surgical procedure, the morbidity and mortality after ECMO in patients undergoing the comprehensive Stage II procedure are similar to those in patients undergoing the Glenn procedure. If needed, ECMO support is reasonable for patients after the comprehensive Stage II procedure. © 2016 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Journey of oocyte from metaphase-I to metaphase-II stage in mammals.

PubMed

Sharma, Alka; Tiwari, Meenakshi; Gupta, Anumegha; Pandey, Ashutosh N; Yadav, Pramod K; Chaube, Shail K

2018-08-01

In mammals, journey from metaphase-I (M-I) to metaphase-II (M-II) is important since oocyte extrude first polar body (PB-I) and gets converted into haploid gamete. The molecular and cellular changes associated with meiotic cell cycle progression from M-I to M-II stage and extrusion of PB-I remain ill understood. Several factors drive oocyte meiosis from M-I to M-II stage. The mitogen-activated protein kinase3/1 (MAPK3/1), signal molecules and Rho family GTPases act through various pathways to drive cell cycle progression from M-I to M-II stage. The down regulation of MOS/MEK/MAPK3/1 pathway results in the activation of anaphase-promoting complex/cyclosome (APC/C). The active APC/C destabilizes maturation promoting factor (MPF) and induces meiotic resumption. Several signal molecules such as, c-Jun N-terminal kinase (JNK2), SENP3, mitotic kinesin-like protein 2 (MKlp2), regulator of G-protein signaling (RGS2), Epsin2, polo-like kinase 1 (Plk1) are directly or indirectly involved in chromosomal segregation. Rho family GTPase is another enzyme that along with cell division cycle (Cdc42) to form actomyosin contractile ring required for chromosomal segregation. In the presence of origin recognition complex (ORC4), eccentrically localized haploid set of chromosomes trigger cortex differentiation and determine the division site for polar body formation. The actomyosin contractile activity at the site of division plane helps to form cytokinetic furrow that results in the formation and extrusion of PB-I. Indeed, oocyte journey from M-I to M-II stage is coordinated by several factors and pathways that enable oocyte to extrude PB-I. Quality of oocyte directly impact fertilization rate, early embryonic development, and reproductive outcome in mammals. © 2018 Wiley Periodicals, Inc.

Patterns of adjuvant chemotherapy for stage II and III colon cancer in France and Italy.

PubMed

Bouvier, Anne-Marie; Minicozzi, Pamela; Grosclaude, Pascale; Bouvier, Véronique; Faivre, Jean; Sant, Milena

2013-08-01

European guidelines recommend adjuvant chemotherapy for stage III colon cancer but not for stage II. To determine the extent to which adjuvant chemotherapy was used in Italy and France. A common retrospective database of 2186 colon cancers diagnosed between 2003 and 2005 was analysed according to age, stage and presenting features. 38.9% of patients with stage II and 64.6% with stage III received chemotherapy in Italy, 21.7% and 65.1% in France. For stage II, the association between country and chemotherapy was only significant in patients diagnosed out of emergency (ORItaly/France: 3.05 [2.12-4.37], p<0.001) whereas patients diagnosed in emergency were as likely to receive chemotherapy in both countries. For stage III, there was a trend to a higher administration of chemotherapy for elderly patients in France compared to Italy. French patients were more likely than Italian to receive chemotherapy (OR: 1.91[1.32-2.78], p=0.001). Chemotherapy for stage III colon cancer was as extensively used in Italy as in France for young patients. Its administration could be increased in patients over 75. Stage II patients with a lower risk of relapse received chemotherapy more often in Italy than in France. Copyright © 2013 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Stage II Chronic Maxillary Atelectasis Associated with Subclinical Visual Field Defect.

PubMed

Mangussi-Gomes, João; Nakanishi, Márcio; Chalita, Maria Regina; Damasco, Fabiana; De Oliveira, Carlos Augusto Costa Pires

2013-10-01

Introduction Chronic maxillary atelectasis (CMA) is characterized by a persistent decrease in the maxillary sinus volume due to inward bowing of its walls. According to its severity, it may be classified into three clinical-radiological stages. Objective To report a case of stage II CMA associated with subclinical visual field defect. Case Report A 34-year-old woman presented with a 15-year history of recurrent episodes of sinusitis and intermittent right facial discomfort for the past 5 years. She denied visual complaints, and no facial deformities were observed on physical examination. Paranasal sinus computed tomography (CT) demonstrated a completely opacified right maxillary sinus with inward bowing of its walls, suggesting the diagnosis of stage II CMA. A computerized campimetry (CC) disclosed a scotoma adjacent to the blind spot of the right eye, indicating a possible damage to the optic nerve. The patient was submitted to functional endoscopic sinus surgery, with drainage of a thick mucous fluid from the sinus. She did well after surgery and has been asymptomatic since then. Postoperative CT was satisfactory and CC was normal. Discussion CMA occurs because of a persistent ostiomeatal obstruction, which creates negative pressure inside the sinus. It is associated with nasosinusal symptoms but had never been described in association with any visual field defect. It can be divided into stage I (membranous deformity), stage II (bony deformity), and stage III (clinical deformity). The silent sinus syndrome is a special form of CMA. This term should only be used to describe those cases with spontaneous enophthalmos, hypoglobus, and/or midfacial deformity in the absence of nasosinusal symptoms.

Adjuvant Chemotherapy for Stage II Right- and Left-Sided Colon Cancer: Analysis of SEER-Medicare Data

PubMed Central

Weiss, Jennifer M.; Schumacher, Jessica; Allen, Glenn O.; Neuman, Heather; Lange, Erin O’Connor; LoConte, Noelle K.; Greenberg, Caprice C.; Smith, Maureen A.

2014-01-01

Purpose Survival benefit from adjuvant chemotherapy is established for stage III colon cancer; however, uncertainty exists for stage II patients. Tumor heterogeneity, specifically microsatellite instability (MSI) which is more common in right-sided cancers, may be the reason for this observation. We examined the relationship between adjuvant chemotherapy and overall 5-year mortality for stage II colon cancer by location (right- versus left-side) as a surrogate for MSI. Methods Using Surveillance, Epidemiology, and End Results (SEER)-Medicare data, we identified Medicare beneficiaries from 1992 to 2005 with AJCC stage II (n=23,578) and III (n=17,148) primary adenocarcinoma of the colon who underwent surgery for curative intent. Overall 5-year mortality was examined with Kaplan-Meier survival analysis and Cox proportional hazards regression with propensity score weighting. Results Eighteen percent (n=2,941) of stage II patients with right-sided cancer and 22% (n=1,693) with left-sided cancer received adjuvant chemotherapy. After adjustment, overall 5-year survival benefit from chemotherapy was observed only for stage III patients (right-sided: HR 0.64; 95% CI, 0.59–0.68, p<0.001 and left-sided: HR 0.61; 95% CI, 0.56–0.68, p<0.001). No survival benefit was observed for stage II patients with either right-sided (HR 0.97; 95% CI, 0.87–1.09, p=0.64) or left-sided cancer (HR 0.97; 95% CI, 0.84–1.12, p=0.68). Conclusions Among Medicare patients with stage II colon cancer, a substantial number receive adjuvant chemotherapy. Adjuvant chemotherapy did not improve overall 5-year survival for either right- or left-sided colon cancers. Our results reinforce existing guidelines and should be considered in treatment algorithms for older adults with stage II colon cancer. PMID:24643898

Short Course Vaginal Cuff Brachytherapy in Treating Patients With Stage I-II Endometrial Cancer

ClinicalTrials.gov

2018-04-17

Endometrial Clear Cell Adenocarcinoma; Endometrial Endometrioid Adenocarcinoma; Endometrial Serous Adenocarcinoma; Stage I Uterine Corpus Cancer; Stage IA Uterine Corpus Cancer; Stage IB Uterine Corpus Cancer; Stage II Uterine Corpus Cancer; Uterine Corpus Carcinosarcoma; Uterine Corpus Sarcoma

Solar thermal upper stage: Economic advantage and development status

NASA Technical Reports Server (NTRS)

Adams, Alan M.

1995-01-01

A solar thermal upper stage (STUS) is envisioned as a propulsive concept for the future. The STUS will be used for low Earth orbit (LEO) to geostationary-Earth orbit (GEO) transfer and for planetary exploration missions. The STUS offers significant performance gains over conventional chemical propulsion systems. These performance gains translate into a more economical, more efficient method of placing useful payloads in space and maximizing the benefits derived from space activity. This paper will discuss the economical advantages of an STUS compared to conventional chemical propulsion systems, the potential market for an STUS, and the recent activity in the development of an STUS. The results of this assessment combined with the performance gains, will provide a strong justification for the development of an STUS.

Description and Survival of Stage I and II Lung Cancer Patients.

PubMed

Pérez-Martínez, Olaia; Vidal-García, Iria; Montero-Martínez, Carmen; Provencio, Mariano; Ruano-Ravina, Alberto

2018-03-16

The objective of our study was to describe the characteristics of patients diagnosed with stage I and II lung cancer in the health area of A Coruña (Galicia) and to determine their overall survival according to certain variables. Retrospective case series in patients diagnosed between January 2011 and December 2015 with stage I and II primary lung cancer with a minimum follow-up of 18 months. 158 patients were included, 99 at stage I, with a median age of 69 years [range 20-90], predominantly men (81%). Adenocarcinoma was the most common histology (52.9%), followed by epidermoid carcinoma (33.1%). Asymptomatic patients (35.9%) presented more frequently in stage I. Median survival was 57 months (95% CI 48.1-65.9), with higher survival among women, patients under 70 years of age, and those who received surgical treatment. Early stage lung cancer in the health area of A Coruña occurs predominantly in men, in advanced age, and with adenocarcinoma histology. Survival was greater among patients with stage I disease, women, individuals aged under 70 years, and those treated surgically. Despite early diagnosis, median survival was less than 5 years. Copyright © 2018 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.

Initial Assessment of the Ares I-X Launch Vehicle Upper Stage to Vibroacoustic Flight Environments

NASA Technical Reports Server (NTRS)

Larko, Jeffrey M.; Hughes, William O.

2008-01-01

The Ares I launch vehicle will be NASA s first new launch vehicle since 1981. Currently in design, it will replace the Space Shuttle in taking astronauts to the International Space Station, and will eventually play a major role in humankind s return to the Moon and eventually to Mars. Prior to any manned flight of this vehicle, unmanned test readiness flights will be flown. The first of these readiness flights, named Ares I-X, is scheduled to be launched in April 2009. The NASA Glenn Research Center is responsible for the design, manufacture, test and analysis of the Ares I-X upper stage simulator (USS) element. As part of the design effort, the structural dynamic response of the Ares I-X launch vehicle to its vibroacoustic flight environments must be analyzed. The launch vehicle will be exposed to extremely high acoustic pressures during its lift-off and aerodynamic stages of flight. This in turn will cause high levels of random vibration on the vehicle's outer surface that will be transmitted to its interior. Critical flight equipment, such as its avionics and flight guidance components are susceptible to damage from this excitation. This study addresses the modelling, analysis and predictions from examining the structural dynamic response of the Ares I-X upper stage to its vibroacoustic excitations. A statistical energy analysis (SEA) model was used to predict the high frequency response of the vehicle at locations of interest. Key to this study was the definition of the excitation fields corresponding to lift off acoustics and the unsteady aerodynamic pressure fluctuations during flight. The predicted results will be used by the Ares I-X Project to verify the flight qualification status of the Ares I-X upper stage components.

ESC-B: The Cryogenic Upper Stage for Europe's Heavy Lift Launcher Ariane 5ECB

NASA Astrophysics Data System (ADS)

Juhls, A.

2002-01-01

-A. Juhls, Astrium GmbH -M. Lepelletier, Snecma Moteurs -JM. Bahu, CNES -C. Poincheval, CNES. In the year 1998 the European ministerial council decided to initiate the Ariane 5 Plus programme in order to upgrade the European heavy lift launcher Ariane 5. The market was changing more rapidly than predicted showing steadily growing satellite mass and the demand for flexible missions while strong competitors were intensifying their preparations to enter the commercial business. The answer was to improve the Ariane 5 launcher by modifying the cryogenic first (or lower ?) stage and the solid boosters and by introducing two cryogenic upper stages in two steps: In order to cope with the short term need of a significant growth of GTO lift capacity up to 10 t the first denoted ESC-A shall enter commercial service in 2002. Four years later a more powerful second version shall take over enabling a GTO performance of 12 t and providing versatile mission capability. The paper will focus on this new cryogenic upper stage denoted ESC-B giving first a general description of main characteristics and constituents. The article will highlight different challenging aspects of the ESC-B development: Ambitious economical conditions regarding both limited development budgets and the strong need to reduce production cost require improved working methods and an adjustment of the conventional development logic, in particular regarding new verification methods. Furthermore Europe is now facing the complex combination of versatile mission capability together with a powerful cryogenic upper stage. The paper will present the approach to define reasonable mission scenarios in order to cover customer demands while avoiding too stringent system requirements. Along with VINCI, Europe's first expander cycle type engine featuring an extendable nozzle dedicated subsystems will be described which allow 4 re-ignitions and 6 hours of ballistic flight. The paper concludes with the summary of the

Taming Liquid Hydrogen: The Centaur Upper Stage Rocket

NASA Technical Reports Server (NTRS)

Dawson, Virginia P.; Bowles, Mark D.

2004-01-01

The Centaur is one of the most powerful rockets in the world. As an upper-stage rocket for the Atlas and Titan boosters it has been a reliable workhorse for NASA for over forty years and has played an essential role in many of NASA's adventures into space. In this CD-ROM you will be able to explore the Centaur's history in various rooms to this virtual museum. Visit the "Movie Theater" to enjoy several video documentaries on the Centaur. Enter the "Interview Booth" to hear and read interviews with scientists and engineers closely responsible for building and operating the rocket. Go to the "Photo Gallery" to look at numerous photos of the rocket throughout its history. Wander into the "Centaur Library" to read various primary documents of the Centaur program. Finally, stop by the "Observation Deck" to watch a virtual Centaur in flight.

Operations analysis (study 2.1): Shuttle upper stage software requirements

NASA Technical Reports Server (NTRS)

Wolfe, R. R.

1974-01-01

An investigation of software costs related to space shuttle upper stage operations with emphasis on the additional costs attributable to space servicing was conducted. The questions and problem areas include the following: (1) the key parameters involved with software costs; (2) historical data for extrapolation of future costs; (3) elements of the basic software development effort that are applicable to servicing functions; (4) effect of multiple servicing on complexity of the operation; and (5) are recurring software costs significant. The results address these questions and provide a foundation for estimating software costs based on the costs of similar programs and a series of empirical factors.

OCO-2 - Delta II Install 2nd Stage Nozzle

NASA Image and Video Library

2014-02-26

VANDENBERG AIR FORCE BASE, Calif. – In the Horizontal Processing Facility at Space Launch Complex 2 on Vandenberg Air Force Base in California, the engine bell is installed around the second-stage nozzle of the Delta II rocket for NASA's Orbiting Carbon Observatory-2 mission, or OCO-2. OCO-2 is scheduled to launch aboard a United Launch Alliance Delta II rocket from Space Launch Complex 2 in July. The rocket's second stage will insert OCO-2 into a polar Earth orbit. OCO-2 will collect precise global measurements of carbon dioxide in the Earth's atmosphere and provide scientists with a better idea of the chemical compound's impacts on climate change. Scientists will analyze this data to improve our understanding of the natural processes and human activities that regulate the abundance and distribution of this important atmospheric gas. To learn more about OCO-2, visit http://oco.jpl.nasa.gov. Photo credit: NASA/Randy Beaudoin

Genomic Biomarkers for the Prediction of Stage and Prognosis of Upper Tract Urothelial Carcinoma.

PubMed

Bagrodia, Aditya; Cha, Eugene K; Sfakianos, John P; Zabor, Emily C; Bochner, Bernard H; Al-Ahmadie, Hikmat A; Solit, David B; Coleman, Jonathan A; Iyer, Gopa; Scott, Sasinya N; Shah, Ronak; Ostrovnaya, Irina; Lee, Byron; Desai, Neil B; Ren, Qinghu; Rosenberg, Jonathan E; Dalbagni, Guido; Bajorin, Dean F; Reuter, Victor E; Berger, Michael F

2016-06-01

Genomic characterization of radical nephroureterectomy specimens in patients with upper tract urothelial carcinoma may allow for thoughtful integration of systemic and targeted therapies. We sought to determine whether genomic alterations in upper tract urothelial carcinoma are associated with adverse pathological and clinical outcomes. Next generation exon capture sequencing of 300 cancer associated genes was performed in 83 patients with upper tract urothelial carcinoma. Genomic alterations were assessed individually and also grouped into core signal transduction pathways or canonical cell functions for association with clinicopathological outcomes. Binary outcomes, including grade (high vs low), T stage (pTa/T1/T2 vs pT3/T4) and organ confined status (pT2 or less and N0/Nx vs greater than pT2 or N+) were assessed with the Kruskal-Wallis and Fisher exact tests as appropriate. Associations between alterations and survival were estimated using the Kaplan-Meier method and Cox regression. Of the 24 most commonly altered genes in 9 pathways TP53/MDM2 alterations and FGFR3 mutations were the only 2 alterations uniformly associated with high grade, advanced stage, nonorgan confined disease, and recurrence-free and cancer specific survival. TP53/MDM2 alterations were associated with adverse clinicopathological outcomes whereas FGFR3 mutations were associated with favorable outcomes. We created a risk score using TP53/MDM2 and FGFR3 status that was able to discriminate between adverse pathological and clinical outcomes, including in the subset of patients with high grade disease. The study is limited by small numbers and lack of validation. Our data indicate that specific genomic alterations in radical nephroureterectomy specimens correlate with tumor grade, stage and cancer specific survival outcomes. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Use and Yield of Baseline Imaging and Laboratory Testing in Stage II Breast Cancer

PubMed Central

Guo, Hao; Sutton, Jazmine; Spring, Laura; Faig, Jennifer; Dagogo-Jack, Ibiayi; Battelli, Chiara; Houlihan, Mary Jane; Yeh, Tsai-Chu; Come, Steven E.; Lin, Nancy U.

2016-01-01

Background. Despite guideline recommendations, baseline laboratory testing and advanced imaging are widely ordered in clinical practice to stage asymptomatic patients with clinical stage II breast cancer (BC). Materials and Methods. A retrospective study at two academic centers in Boston, Massachusetts, between 2006 and 2007 explored the use, results, and implications of laboratory tests, tumor markers, and imaging in patients with clinical stage II BC. Results. Among 411 patients, 233 (57%) had liver function testing, 134 (33%) had tumor marker tests, and 237 (58%) had computed tomography (CT) as part of their initial diagnostic workup. Median age was 52 (range, 23–90 years). On multivariable analysis, young age, more advanced stage, and tumor subtype (human epidermal growth receptor-positive [HER2+] and triple-negative breast cancer [TNBC]) were significantly associated with baseline CT. The rate of detection of true metastatic disease with use of baseline staging imaging was 2.1% (95% confidence interval, 0.7%–5%). It was 2.2% (3 of 135) for estrogen receptor/progesterone receptor-positive disease, 1.9% (1 of 54) for HER2+ disease, and 2.1% (1 of 48) for TNBC. At 5 years of follow-up, 46 of 406 patients were diagnosed with metastatic breast cancer. Thirty-four of 46 (73.9%) who developed recurrent disease had imaging at their initial diagnosis, and of these, five had abnormalities on their initial imaging that was correlated with where they developed metastatic disease. Conclusion. In this cohort of women with stage II BC, staging imaging at diagnosis had a low yield in detecting distant metastases (2.1%). The detection rate was not higher with HER2+ disease or TNBC, despite the trend that patients with these subtypes were more likely to undergo imaging. Implications for Practice: Despite guideline recommendations, asymptomatic patients with stage II breast cancer (BC) often undergo staging imaging with computed tomography, bone scanning, or positron

Risk Assessment Challenges in the Ares I Upper Stage

NASA Technical Reports Server (NTRS)

Stott, James E.; Ring, Robert W.; Elrada, Hassan A.; Hark, Frank

2007-01-01

NASA Marshall Space Flight Center (MSFC) is currently at work developing hardware and systems for the Ares I rocket that will send future astronauts into orbit. Built on cutting-edge launch technologies, evolved powerful Apollo and Space Shuttle propulsion elements, and decades of NASA spaceflight experience, Ares I is the essential core of a safe, reliable, cost-effective space transportation system -- one that will carry crewed missions back to the moon, on to Mars and out into the solar system. Ares I is an in-line, two-stage rocket configuration topped by the Orion crew vehicle and its launch abort system. In addition to the vehicle's primary mission -carrying crews of four to six astronauts to Earth orbit --Ares I may also use its 25-ton payload capacity to deliver resources and supplies to the International Space Station, or to "park" payloads in orbit for retrieval by other spacecraft bound for the moon or other destinations. Crew transportation to the International Space Station is planned to begin no later than 2014. The first lunar excursion is scheduled for the 2020 timeframe. This paper presents the challenges in designing the Ares I upper stage for reliability and safety while minimizing weight and maximizing performance.

CD44v6 expression in patients with stage II or stage III sporadic colorectal cancer is superior to CD44 expression for predicting progression

PubMed Central

Zhao, LH; Lin, QL; Wei, J; Huai, YL; Wang, KJ; Yan, HY

2015-01-01

Background: Currently, it is difficult to predict the prognosis of patients exhibiting stage II or stage III colorectal cancer (CRC) and to identify those patients most likely to benefit from aggressive treatment. The current study was performed to examine the clinicopathological significance of CD44 and CD44v6 protein expression in these patients. Study design: We retrospectively investigated 187 consecutive patients who underwent surgery with curative intent for stage II to III CRC from 2007 to 2013 in the Beijing Civil Aviation Hospital. CD44 and CD44v6 protein expression levels were determined using immunohistochemistry and compared to the clinicopathological data. Results: Using immunohistochemical detection, CD44 expression was observed in 108 (57.75%) of the CRC patients; and its detection was significantly associated with greater invasion depth, lymph node metastasis, angiolymphatic invasion, and a more advanced pathological tumor-lymph node-metastasis (TNM) stage. CD44v6 expression was observed in 135 (72.19%) of the CRC patients; and its expression was significantly associated with a poorly differentiated histology, greater invasion depth, lymph node metastasis, angiolymphatic invasion, and a more advanced pathological TNM stage. Expression of CD44v6 was higher than that of CD44 in stage II and stage III sporadic CRC. Conclusion: CD44v6 is a more useful marker for predicting a poor prognosis in stage II and stage III sporadic CRC as compared to CD44. PMID:25755763

Upper Stratospheric Temperature Climatology Derived from SAGE II Observations: Preliminary Results

NASA Technical Reports Server (NTRS)

Wang, P.-H.; Cunnold, D. M.; Wang, H. J.; Chu, W. P.; Thomason, L. W.

2002-01-01

This study shows that the temperature information in the upper stratosphere can be derived from the SAGE II 385-mn observations. The preliminary results indicate that the zonal mean temperature increases with altitude below 50 km and decreases above 50 km. At 50 km, a regional maximum of 263 K is located in the tropics, and a minimum of 261 K occurs in the subtropics in both hemispheres. The derived long-term temperature changes from 1985 to 1997 reveal a statistically significant negative trend of -2 to -2.5 K/decade in the tropical upper stratosphere and about -2 K/decade in the subtropics near the stratopause. At latitudes poleward of 50, the results show a statistically significant positive trend of about 1 K/decade in the upper stratosphere. The preliminary results also show large annual temperature oscillations in the extratropics with a maximum amplitude of approx. 8 K located at about 44 km near 50 in both hemispheres during local summer. In addition, the semiannual oscillation is found to be a maximum in the tropics with a peak amplitude of approx. 3.3 K located at about 42 km during the equinox.

Breast-Conserving Surgery Followed by Radiation Therapy With MRI-Detected Stage I or Stage II Breast Cancer

ClinicalTrials.gov

2011-12-07

Ductal Breast Carcinoma in Situ; Estrogen Receptor-negative Breast Cancer; Estrogen Receptor-positive Breast Cancer; HER2-negative Breast Cancer; HER2-positive Breast Cancer; Invasive Ductal Breast Carcinoma; Invasive Lobular Breast Carcinoma; Male Breast Cancer; Medullary Ductal Breast Carcinoma With Lymphocytic Infiltrate; Mucinous Ductal Breast Carcinoma; Papillary Ductal Breast Carcinoma; Progesterone Receptor-negative Breast Cancer; Progesterone Receptor-positive Breast Cancer; Stage I Breast Cancer; Stage II Breast Cancer; Tubular Ductal Breast Carcinoma

PTT functional recovery in early stage II PTTD after tendon balancing and calcaneal lengthening osteotomy.

PubMed

Brilhault, Jean; Noël, Vincent

2012-10-01

The decision to offer surgery for Stage II posterior tibial tendon deficiency (PTTD) is a difficult one since orthotic treatment has been documented to be a viable alternative to surgery at this stage. Taking this into consideration we limited our treatment to bony realignment by a lengthening calcaneus Evans osteotomy and tendon balancing. The goal of the study was to clinically evaluate PTT functional recovery with this procedure. The patient population included 17 feet in 13 patients. Inclusion was limited to early Stage II PTTD flatfeet with grossly intact but deficient PTT. Deficiency was assessed by the lack of hindfoot inversion during single heel rise test. The surgical procedure included an Evans calcaneal opening wedge osteotomy with triceps surae and peroneus brevis tendon lengthening. PTT function at follow up was evaluated by an independent examiner. Evaluation was performed at an average of 4 (range, 2 to 6.3) years. One case presented postoperative subtalar pain that required subtalar fusion. Every foot could perform a single heel rise with 13 feet having active inversion of the hindfoot during elevation. The results of this study provide evidence of PTT functional recovery without augmentation in early Stage II. It challenges our understanding of early Stage II PTTD as well as the surgical guidelines recommending PTT augmentation at this specific stage.

Changes in Brain Function in Patients With Stage I, Stage II, Stage III, or Stage IV Ovarian, Primary Peritoneal, or Fallopian Tube Cancer Who Are Receiving Chemotherapy

ClinicalTrials.gov

2018-04-11

Cognitive Side Effects of Cancer Therapy; Malignant Ovarian Epithelial Tumor; Ovarian Brenner Tumor; Ovarian Carcinosarcoma; Ovarian Choriocarcinoma; Ovarian Clear Cell Cystadenocarcinoma; Ovarian Dysgerminoma; Ovarian Embryonal Carcinoma; Ovarian Endometrioid Adenocarcinoma; Ovarian Mixed Germ Cell Tumor; Ovarian Mucinous Cystadenocarcinoma; Ovarian Polyembryoma; Ovarian Sarcoma; Ovarian Seromucinous Carcinoma; Ovarian Serous Cystadenocarcinoma; Ovarian Teratoma; Ovarian Yolk Sac Tumor; Stage I Ovarian Cancer; Stage IA Fallopian Tube Cancer; Stage IA Ovarian Cancer; Stage IA Ovarian Germ Cell Tumor; Stage IB Fallopian Tube Cancer; Stage IB Ovarian Cancer; Stage IB Ovarian Germ Cell Tumor; Stage IC Fallopian Tube Cancer; Stage IC Ovarian Cancer; Stage IC Ovarian Germ Cell Tumor; Stage II Ovarian Cancer; Stage IIA Fallopian Tube Cancer; Stage IIA Ovarian Cancer; Stage IIA Ovarian Germ Cell Tumor; Stage IIB Fallopian Tube Cancer; Stage IIB Ovarian Cancer; Stage IIB Ovarian Germ Cell Tumor; Stage IIC Fallopian Tube Cancer; Stage IIC Ovarian Cancer; Stage IIC Ovarian Germ Cell Tumor; Stage IIIA Fallopian Tube Cancer; Stage IIIA Ovarian Cancer; Stage IIIA Ovarian Germ Cell Tumor; Stage IIIA Primary Peritoneal Cancer; Stage IIIB Fallopian Tube Cancer; Stage IIIB Ovarian Cancer; Stage IIIB Ovarian Germ Cell Tumor; Stage IIIB Primary Peritoneal Cancer; Stage IIIC Fallopian Tube Cancer; Stage IIIC Ovarian Cancer; Stage IIIC Ovarian Germ Cell Tumor; Stage IIIC Primary Peritoneal Cancer; Stage IV Fallopian Tube Cancer; Stage IV Ovarian Cancer; Stage IV Ovarian Germ Cell Tumor; Stage IV Primary Peritoneal Cancer; Undifferentiated Ovarian Carcinoma

Migration and winter distributions of canvasbacks staging on the Upper Mississippi River

USGS Publications Warehouse

Serie, J.R.; Trauger, D.L.; Sharp, D.E.

1983-01-01

Fall and winter distribution patterns of canvasbacks (Aythya valisineria) staging on the upper Mississippi River near LaCrosse, Wisconsin (navigational Pools 7 and 8) and Keokuk, Iowa (Pool 19) were studied during 1973-77. Sightings and recoveries obtained from 1,488 color-marked males during 1973-75 and 3,789 banded males and females during 1973-77 suggested 2 principal migration corridors: 1 extending eastward from Pools 7 and 8 to the eastern Great Lakes and southeast to the Mid-Atlantic Region and another southward from Pools 7 and 8 to the lower Mississippi Valley, Gulf Coast, and east Texas regions. These discrete populations stage concurrently on Pools 7 and 8 during the fall, but winter in different areas of the Atlantic, Mississippi, and Central flyways. Populations staging on Pool 19 were not discrete from those staging on Pools 7 and 8. A continual turnover of birds passing through these staging areas was indicated. Canvasbacks wintering in the Mississippi and Central flyways were widely dispersed among a variety of habitats, whereas canvasbacks wintering in the Atlantic Flyway were concentrated in a few traditional habitats. Canvasbacks exhibited strong fidelity to wintering areas. Distribution patterns and population attributes of canvasbacks during fall and winter may be explained by the predictability of natural foods and their ability to exploit these foods.

Neo-adjuvant Therapy With Anastrozole Plus Pazopanib in Stage II and III ER+ Breast Cancer

ClinicalTrials.gov

2017-03-29

Estrogen Receptor-positive Breast Cancer; Human Epidermal Growth Factor 2 Negative Carcinoma of Breast; Male Breast Cancer; Recurrent Breast Cancer; Stage II Breast Cancer; Stage IIIA Breast Cancer; Stage IIIB Breast Cancer

Overview of the Main Propulsion System for the NASA Ares I Upper Stage

NASA Technical Reports Server (NTRS)

Quinn, Jason E.; Swanson, Luke A.

2009-01-01

A functional overview of the Main Propulsion System (MPS) of the NASA Ares I Upper Stage is provided. In addition to a simple overview of the key MPS functions and design philosophies, major lessons learned are discussed. The intent is to provide a technical overview with enough detail to allow engineers outside of the MPS Integrated Product Team (IPT) to develop a rough understanding of MPS operations, components, design philosophy, and lessons learned.

A Multi-Stage Longitudinal Comparative Design Stage II Evaluation of the Changing Lives Program: The Life Course Interview (RDA-LCI)

ERIC Educational Resources Information Center

Arango, Lisa Lewis; Kurtines, William M.; Montgomery, Marilyn J.; Ritchie, Rachel

2008-01-01

The study reported in this article, a Multi-Stage Longitudinal Comparative Design Stage II evaluation conducted as a planned preliminary efficacy evaluation (psychometric evaluation of measures, short-term controlled outcome studies, etc.) of the Changing Lives Program (CLP), provided evidence for the reliability and validity of the qualitative…

78 FR 58184 - Approval and Promulgation of Implementation Plans; North Carolina; Removal of Stage II Gasoline...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-23

...] Approval and Promulgation of Implementation Plans; North Carolina; Removal of Stage II Gasoline Vapor... measures for new and upgraded gasoline dispensing facilities in the State. The September 18, 2009, SIP... .0953), entitled Vapor Return Piping for Stage II Vapor Recovery, for all new or improved gasoline tanks...

18F-FDG PET/CT as a staging procedure in primary stage II and III breast cancer: comparison with conventional imaging techniques.

PubMed

Koolen, Bas B; Vrancken Peeters, Marie-Jeanne T F D; Aukema, Tjeerd S; Vogel, Wouter V; Oldenburg, Hester S A; van der Hage, Jos A; Hoefnagel, Cornelis A; Stokkel, Marcel P M; Loo, Claudette E; Rodenhuis, Sjoerd; Rutgers, Emiel J Th; Valdés Olmos, Renato A

2012-01-01

The aim of the present study was to investigate if 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) outperforms conventional imaging techniques for excluding distant metastases prior to neoadjuvant chemotherapy (NAC) treatment in patients with stage II and III breast cancer. Second, we assessed the clinical importance of false positive findings. One hundred and fifty four patients with stage II or III breast cancer, scheduled to receive NAC, underwent an 18F-FDG PET/CT scan and conventional imaging, consisting of bone scintigraphy, ultrasound of the liver, and chest radiography. Suspect additional lesions at staging examination were confirmed by biopsy and histopathology and/or additional imaging. Metastases that were detected within 6 months after the PET/CT scan were considered evidence of occult metastasis, missed by staging examination. Forty-two additional distant lesions were seen in 25 patients with PET/CT and could be confirmed in 20 (13%) of 154 patients. PET/CT was false positive for 8 additional lesions (19%) and misclassified the presence of metastatic disease in 5 (3%) of 154 patients. In 16 (80%) of 20 patients, additional lesions were exclusively seen with PET/CT, leading to a change in treatment in 13 (8%) of 154 patients. In 129 patients with a negative staging PET/CT, no metastases developed during the follow-up of 9.0 months. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of PET/CT in the detection of additional distant lesions in patients with stage II or III breast cancer are 100, 96, 80, 100, and 97%, respectively. FDG PET/CT is superior to conventional imaging techniques in the detection of distant metastases in patients with untreated stage II or III breast cancer and is associated with a low false positive rate. PET/CT may be of additional value in the staging of breast cancer prior to NAC.

Combination Chemotherapy and Lenalidomide in Treating Patients With Newly Diagnosed Stage II-IV Peripheral T-cell Non-Hodgkin's Lymphoma

ClinicalTrials.gov

2017-07-07

Anaplastic Large Cell Lymphoma, ALK-Negative; Anaplastic Large Cell Lymphoma, ALK-Positive; Hepatosplenic T-Cell Lymphoma; Peripheral T-Cell Lymphoma, Not Otherwise Specified; Stage II Angioimmunoblastic T-cell Lymphoma; Stage II Enteropathy-Associated T-Cell Lymphoma; Stage III Angioimmunoblastic T-cell Lymphoma; Stage III Enteropathy-Associated T-Cell Lymphoma; Stage IV Angioimmunoblastic T-cell Lymphoma; Stage IV Enteropathy-Associated T-Cell Lymphoma

[Effect of soft tissue thickness of upper lip on lip retraction in orthodontical-treated Class II, Division 1 females].

PubMed

Zou, Lanyi; Chen, Yunjia; Liu, Henglang; Na, Bi; He, Jinlong; Fan, Xiaoping

2016-04-01

To establish the Chinese Han national criteria for the thickness of upper lip in Chongqing and to investigate the effect of lip thickness on lip retraction in orthodontic treatment.
 A total of 240 adult patients (male=120, female=120) of Chinese Han nationality aged 18-35 years in Chongqing were treated with cephalograms and measured the thickness of upper lip. We established the Chinese Han national criteria for the thickness of upper lip in Chongqing according to the results. Sixty-eight female patients with Angle II 1 from Department of Orthodontics Stomatological Hospital of Chongqing Medical University were treated with maxillary premolars extraction, and pre- and post-treated with lateral cephalograms, then divided into 3 groups according to our criteria: a thin lips group, a normal lips group and a thick lips group. The ratio of the incisors retraction and the upper lip retraction were measured and calculated. The correlation between incisors retraction and the upper lip retraction was analyzed by the Pearson correlation method.
 There was statistical significance in the thickness of upper lip between males and females (P<0.01). The ratio of maxillary inscior retraction to the upper lip soft tissue retraction was 1.6:1, 2.2:1 and 2.9:1 in the thin lips group, the normal lips group and the thick lips group, respectively.
 Gender differences exist in the thickness of upper lip. Upper lip retraction with the incisors was negatively correlated with the soft tissue thickness of the upper lip in females with Angle II 1.

Novel histopathologic feature identified through image analysis augments stage II colorectal cancer clinical reporting

PubMed Central

Caie, Peter D.; Zhou, Ying; Turnbull, Arran K.; Oniscu, Anca; Harrison, David J.

2016-01-01

A number of candidate histopathologic factors show promise in identifying stage II colorectal cancer (CRC) patients at a high risk of disease-specific death, however they can suffer from low reproducibility and none have replaced classical pathologic staging. We developed an image analysis algorithm which standardized the quantification of specific histopathologic features and exported a multi-parametric feature-set captured without bias. The image analysis algorithm was executed across a training set (n = 50) and the resultant big data was distilled through decision tree modelling to identify the most informative parameters to sub-categorize stage II CRC patients. The most significant, and novel, parameter identified was the ‘sum area of poorly differentiated clusters’ (AreaPDC). This feature was validated across a second cohort of stage II CRC patients (n = 134) (HR = 4; 95% CI, 1.5– 11). Finally, the AreaPDC was integrated with the significant features within the clinical pathology report, pT stage and differentiation, into a novel prognostic index (HR = 7.5; 95% CI, 3–18.5) which improved upon current clinical staging (HR = 4.26; 95% CI, 1.7– 10.3). The identification of poorly differentiated clusters as being highly significant in disease progression presents evidence to suggest that these features could be the source of novel targets to decrease the risk of disease specific death. PMID:27322148

Paclitaxel, Bevacizumab And Adjuvant Intraperitoneal Carboplatin in Treating Patients Who Had Initial Debulking Surgery for Stage II, Stage III, or Stage IV Ovarian Epithelial, Primary Peritoneal, or Fallopian Tube Cancer

ClinicalTrials.gov

2014-06-18

Brenner Tumor; Fallopian Tube Cancer; Ovarian Clear Cell Cystadenocarcinoma; Ovarian Endometrioid Adenocarcinoma; Ovarian Mixed Epithelial Carcinoma; Ovarian Mucinous Cystadenocarcinoma; Ovarian Serous Cystadenocarcinoma; Ovarian Undifferentiated Adenocarcinoma; Primary Peritoneal Cavity Cancer; Stage II Ovarian Epithelial Cancer; Stage III Ovarian Epithelial Cancer; Stage IV Ovarian Epithelial Cancer

Stage Separation Failure: Model Based Diagnostics and Prognostics

NASA Technical Reports Server (NTRS)

Luchinsky, Dmitry; Hafiychuk, Vasyl; Kulikov, Igor; Smelyanskiy, Vadim; Patterson-Hine, Ann; Hanson, John; Hill, Ashley

2010-01-01

Safety of the next-generation space flight vehicles requires development of an in-flight Failure Detection and Prognostic (FD&P) system. Development of such system is challenging task that involves analysis of many hard hitting engineering problems across the board. In this paper we report progress in the development of FD&P for the re-contact fault between upper stage nozzle and the inter-stage caused by the first stage and upper stage separation failure. A high-fidelity models and analytical estimations are applied to analyze the following sequence of events: (i) structural dynamics of the nozzle extension during the impact; (ii) structural stability of the deformed nozzle in the presence of the pressure and temperature loads induced by the hot gas flow during engine start up; and (iii) the fault induced thrust changes in the steady burning regime. The diagnostic is based on the measurements of the impact torque. The prognostic is based on the analysis of the correlation between the actuator signal and fault-induced changes in the nozzle structural stability and thrust.

Safety and Mission Assurance for In-House Design Lessons Learned from Ares I Upper Stage

NASA Technical Reports Server (NTRS)

Anderson, Joel M.

2011-01-01

This viewgraph presentation identifies lessons learned in the course of the Ares I Upper Stage design and in-house development effort. The contents include: 1) Constellation Organization; 2) Upper Stage Organization; 3) Presentation Structure; 4) Lesson-Importance of Systems Engineering/Integration; 5) Lesson-Importance of Early S&MA Involvement; 6) Lesson-Importance of Appropriate Staffing Levels; 7) Lesson-Importance S&MA Team Deployment; 8) Lesson-Understanding of S&MA In-Line Engineering versus Assurance; 9) Lesson-Importance of Close Coordination between Supportability and Reliability/Maintainability; 10) Lesson-Importance of Engineering Data Systems; 11) Lesson-Importance of Early Development of Supporting Databases; 12) Lesson-Importance of Coordination with Safety Assessment/Review Panels; 13) Lesson-Implementation of Software Reliability; 14) Lesson-Implementation of S&MA Technical Authority/Chief S&MA Officer; 15) Lesson-Importance of S&MA Evaluation of Project Risks; 16) Lesson-Implementation of Critical Items List and Government Mandatory Inspections; 17) Lesson-Implementation of Critical Items List Mandatory Inspections; 18) Lesson-Implementation of Test Article Safety Analysis; and 19) Lesson-Importance of Procurement Quality.

Overview of the Beta II Two-Stage-To-Orbit vehicle design

NASA Technical Reports Server (NTRS)

Plencner, Robert M.

1991-01-01

A study of a near-term, low risk two-stage-to-orbit (TSTO) vehicle was undertaken. The goal of the study was to assess a fully reusable TSTO vehicle with horizontal takeoff and landing capability that could deliver 10,000 pounds to a 120 nm polar orbit. The configuration analysis was based on the Beta vehicle design. A cooperative study was performed to redesign and refine the Beta concept to meet the mission requirements. The vehicle resulting from this study was named Beta II. It has an all-airbreathing first stage and a staging Mach number of 6.5. The second stage is a conventional wing-body configuration with a single SSME.

Reduced upper obstructions in N3 and increased lower obstructions in REM sleep stage detected with manometry.

PubMed

Wirth, Markus; Schramm, Juliane; Bautz, Maximilian; Hofauer, Benedikt; Edenharter, Günther; Ott, Armin; Heiser, Clemens

2018-01-01

In obstructive sleep apnea (OSA), airway obstruction occurs at different anatomic levels. The frequency and location of obstructions play a crucial role in the planning of surgical treatment. The aim of this study was to evaluate the pharyngeal obstruction levels in different sleep stages with manometry in OSA patients. In addition, the manometry results were compared with drug-induced sleep endoscopy (DISE). Forty-one patients with OSA received manometry measurements during one night of sleep. All patients were simultaneously evaluated with polysomnography. The frequency of obstructions in different sleep stages was assessed. Twenty patients were additionally studied with DISE. Obstruction levels detected with manometry were compared with DISE. The frequency of upper and to a lesser extent lower obstructions decreased in sleep stage N3. In rapid eye movement (REM) sleep, lower obstructions increased. The overall proportion of upper and lower obstructions detected with manometry corresponded with DISE in 13 of 20 cases. A significant change in the obstruction levels was detected with manometry in N3 and REM sleep. The reduction of both upper and to a lesser extent lower obstructions in N3 suggests more stable airways in slow-wave sleep. Relevant lower obstructions were not detected in DISE compared to manometry in 5 out of 20 examinations. This could be a potential reason for treatment failure of site-specific surgical OSA treatment when only performing DISE preoperatively. Therefore, manometry could be a useful complementary tool in the preoperative evaluation for OSA.

Saturn V Second Stage (S-II) Ready for Static Test

NASA Technical Reports Server (NTRS)

1965-01-01

Two workers are dwarfed by the five J-2 engines of the Saturn V second stage (S-II) as they make final inspections prior to a static test firing by North American Space Division. These five hydrogen -fueled engines produced one million pounds of thrust, and placed the Apollo spacecraft into earth orbit before departing for the moon. The towering 363-foot Saturn V was a multi-stage, multi-engine launch vehicle standing taller than the Statue of Liberty. Altogether, the Saturn V engines produced as much power as 85 Hoover Dams.

Doxorubicin Hydrochloride, Vinblastine, Dacarbazine, Brentuximab Vedotin, and Nivolumab in Treating Patients With Stage I-II Hodgkin Lymphoma

ClinicalTrials.gov

2018-04-30

Ann Arbor Stage I Hodgkin Lymphoma; Ann Arbor Stage IA Hodgkin Lymphoma; Ann Arbor Stage IB Hodgkin Lymphoma; Ann Arbor Stage II Hodgkin Lymphoma; Ann Arbor Stage IIA Hodgkin Lymphoma; Ann Arbor Stage IIB Hodgkin Lymphoma

Fulvestrant and/or Anastrozole in Treating Postmenopausal Patients With Stage II-III Breast Cancer Undergoing Surgery

ClinicalTrials.gov

2018-06-08

Estrogen Receptor-positive Breast Cancer; HER2-negative Breast Cancer; Invasive Ductal Breast Carcinoma; Invasive Lobular Breast Carcinoma; Recurrent Breast Cancer; Stage II Breast Cancer; Stage IIIA Breast Cancer; Stage IIIB Breast Cancer; Stage IIIC Breast Cancer

Brentuximab Vedotin and Combination Chemotherapy in Treating Patients With Stage II-IV HIV-Associated Hodgkin Lymphoma

ClinicalTrials.gov

2018-06-11

AIDS-Related Hodgkin Lymphoma; Ann Arbor Stage II Hodgkin Lymphoma; Ann Arbor Stage IIA Hodgkin Lymphoma; Ann Arbor Stage IIB Hodgkin Lymphoma; Ann Arbor Stage III Hodgkin Lymphoma; Ann Arbor Stage IIIA Hodgkin Lymphoma; Ann Arbor Stage IIIB Hodgkin Lymphoma; Ann Arbor Stage IV Hodgkin Lymphoma; Ann Arbor Stage IVA Hodgkin Lymphoma; Ann Arbor Stage IVB Hodgkin Lymphoma; Classic Hodgkin Lymphoma; HIV Infection

Development of the arterial pattern in the upper limb of staged human embryos: normal development and anatomic variations

PubMed Central

RODRÍGUEZ-NIEDENFÜHR, M.; BURTON, G. J.; DEU, J.; SAÑUDO, J. R.

2001-01-01

A total of 112 human embryos (224 upper limbs) between stages 12 and 23 of development were examined. It was observed that formation of the arterial system in the upper limb takes place as a dual process. An initial capillary plexus appears from the dorsal aorta during stage 12 and develops at the same rate as the limb. At stage 13, the capillary plexus begins a maturation process involving the enlargement and differentiation of selected parts. This remodelling process starts in the aorta and continues in a proximal to distal sequence. By stage 15 the differentiation has reached the subclavian and axillary arteries, by stage 17 it has reached the brachial artery as far as the elbow, by stage 18 it has reached the forearm arteries except for the distal part of the radial, and finally by stage 21 the whole arterial pattern is present in its definitive morphology. This differentiation process parallels the development of the skeletal system chronologically. A number of arterial variations were observed, and classified as follows: superficial brachial (7.7%), accessory brachial (0.6%), brachioradial (14%), superficial brachioulnar (4.7%), superficial brachioulnoradial (0.7%), palmar pattern of the median (18.7%) and superficial brachiomedian (0.7%) arteries. They were observed in embryos belonging to stages 17–23 and were not related to a specific stage of development. Statistical comparison with the rates of variations reported in adults did not show significant differences. It is suggested that the variations arise through the persistence, enlargement and differentiation of parts of the initial network which would normally remain as capillaries or even regress. PMID:11693301

Effects of virtual reality training with modified constraint-induced movement therapy on upper extremity function in acute stage stroke: a preliminary study.

PubMed

Ji, Eun-Kyu; Lee, Sang-Heon

2016-11-01

[Purpose] The purpose of this study was to investigate the effects of virtual reality training combined with modified constraint-induced movement therapy on upper extremity motor function recovery in acute stage stroke patients. [Subjects and Methods] Four acute stage stroke patients participated in the study. A multiple baseline single subject experimental design was utilized. Modified constraint-induced movement therapy was used according to the EXplaining PLastICITy after stroke protocol during baseline sessions. Virtual reality training with modified constraint-induced movement therapy was applied during treatment sessions. The Manual Function Test and the Box and Block Test were used to measure upper extremity function before every session. [Results] The subjects' upper extremity function improved during the intervention period. [Conclusion] Virtual reality training combined with modified constraint-induced movement is effective for upper extremity function recovery in acute stroke patients.

Large Scale Testing of a Foam/Multilayer Insulation Thermal Control System (TCS) for Cryogenic Upper Stages

NASA Technical Reports Server (NTRS)

Hastings, Leon; Martin, James

1998-01-01

The development of high energy cryogenic upper stages is essential for the efficient delivery of large payloads to various destinations envisioned in future programs. A key element in such upper stages is cryogenic fluid management (CFM) advanced development/technology. Due to the cost of and limited opportunities for orbital experiments, ground testing must be employed to the fullest extent possible. Therefore, a system level test bed termed the Multipurpose Hydrogen Test Bed (MHTB), which is representative in size and shape (3 meter diameter by 3 meter long with a volume of 18 cubic meters) of a fully integrated space transportation vehicle liquid hydrogen propellant tank has been established. To date, upper stage studies have often baselined the foam/multilayer insulation (FMLI) combination concept; however, hardware experience with the concept is minimal and was therefore selected for the MHTB. The foam element (isofoam SS-1 171 with an average thickness of 3.5 centimeters) is designed to protect against ground hold/ascent flight environments, and allows for the use of a dry nitrogen purge as opposed to the more complex/heavy helium purge subsystem normally required with MLI in cryogenic applications. The MLI (45 layers of Double Aluminized Mylar with Dacron spacers) provides protection in the vacuum environment of space and is designed for an on-orbit storage period of 45 days. Several unique features were incorporated in the MLI concept and included: variable density MLI (reduces weight and radiation losses by changing the layer density), larger but fewer DAM perforations for venting during ascent to orbit (reduces radiation losses), and roll wrap installation of the MLI with a commercially established process to lower assembly man-hours and reduce seam heat leak. Thermal performance testing of the MHTB TCS was conducted during three test series conducted between September 1995 and May 1996. Results for the ground hold portion of the tests were as expected

OCO-2-Delta II 2nd Stage Arrival

NASA Image and Video Library

2014-02-21

VANDENBERG AIR FORCE BASE, Calif. – The second stage for NASA's Orbiting Carbon Observatory-2 mission, or OCO-2, arrives at the Building 836 hangar on Vandenberg Air Force Base in California. OCO-2 is scheduled to launch aboard a United Launch Alliance Delta II rocket from Space Launch Complex 2 in July. The rocket's second stage will insert OCO-2 into a polar Earth orbit. OCO-2 will collect precise global measurements of carbon dioxide in the Earth's atmosphere and provide scientists with a better idea of the chemical compound's impacts on climate change. Scientists will analyze this data to improve our understanding of the natural processes and human activities that regulate the abundance and distribution of this important atmospheric gas. To learn more about OCO-2, visit http://oco.jpl.nasa.gov. Photo credit: NASA/Randy Beaudoin

Hot-Fire Test of Liquid Oxygen/Hydrogen Space Launch Mission Injector Applicable to Exploration Upper Stage

NASA Technical Reports Server (NTRS)

Barnett, Greg; Turpin, Jason; Nettles, Mindy

2015-01-01

This task is to hot-fire test an existing Space Launch Mission (SLM) injector that is applicable for all expander cycle engines being considered for the exploration upper stage. The work leverages investment made in FY 2013 that was used to additively manufacture three injectors (fig. 1) all by different vendors..

Decadal-Scale Responses in Middle and Upper Stratospheric Ozone From SAGE II Version 7 Data

NASA Technical Reports Server (NTRS)

Remsberg, E. E.

2014-01-01

Stratospheric Aerosol and Gas Experiment (SAGE II) version 7 (v7) ozone profiles are analyzed for their decadal-scale responses in the middle and upper stratosphere for 1991 and 1992-2005 and compared with those from its previous version 6.2 (v6.2). Multiple linear regression (MLR) analysis is applied to time series of its ozone number density vs. altitude data for a range of latitudes and altitudes. The MLR models that are fit to the time series data include a periodic 11 yr term, and it is in-phase with that of the 11 yr, solar UV (Ultraviolet)-flux throughout most of the latitude/ altitude domain of the middle and upper stratosphere. Several regions that have a response that is not quite in-phase are interpreted as being affected by decadal-scale, dynamical forcings. The maximum minus minimum, solar cycle (SClike) responses for the ozone at the low latitudes are similar from the two SAGE II data versions and vary from about 5 to 2.5% from 35 to 50 km, although they are resolved better with v7. SAGE II v7 ozone is also analyzed for 1984-1998, in order to mitigate effects of end-point anomalies that bias its ozone in 1991 and the analyzed results for 1991-2005 or following the Pinatubo eruption. Its SC-like ozone response in the upper stratosphere is of the order of 4%for 1984-1998 vs. 2.5 to 3%for 1991-2005. The SAGE II v7 results are also recompared with the responses in ozone from the Halogen Occultation Experiment (HALOE) that are in terms of mixing ratio vs. pressure for 1991-2005 and then for late 1992- 2005 to avoid any effects following Pinatubo. Shapes of their respective response profiles agree very well for 1992-2005. The associated linear trends of the ozone are not as negative in 1992-2005 as in 1984-1998, in accord with a leveling off of the effects of reactive chlorine on ozone. It is concluded that the SAGE II v7 ozone yields SC-like ozone responses and trends that are of better quality than those from v6.2.

Cephalometric evaluation of the effects of the Twin Block appliance in subjects with Class II, Division 1 malocclusion amongst different cervical vertebral maturation stages.

PubMed

Khoja, Aisha; Fida, Mubassar; Shaikh, Attiya

2016-06-01

To evaluate the cephalometric changes in skeletal, dentoalveolar and soft tissue variables induced by Clark's Twin Block (CTB) in Class II, Division 1 malocclusion patients and to compare these changes in different cervical vertebral maturation stages. Pre- and post-treatment/observation lateral cephalograms of 53 Class II, Division 1 malocclusion patients and 60 controls were compared to evaluate skeletal, dentoalveolar and soft tissue changes. Skeletal maturity was assessed according to cervical vertebral maturation stages. Pre- and post-treatment/observation mean changes and differences (T2-T1) were compared by means of Wilcoxon sign rank and Mann-Whitney U-tests, respectively. Intergroup comparisons between different cervical stages were performed by means of Kruskal-Wallis test and Mann-Whitney U-test (p ≤ 0.05) . When compared with controls, there was a significant reduction in ANB angle (p < 0.001), which was due to a change in SNB angle in CS-2 and CS-3 (p < 0.001), and in SNA (p < 0.001) and SNB (p = 0.016) angles in the CS-4 group. There was significant increase in the GoGn-SN angle in CS-2 (p = 0.007) and CS-4 (p = 0.024), and increase in Co-Gn and Go-Gn amongst all cervical stages (p < 0.05). There was significant decrease in U1-SN and increase in IMPA amongst all cervical stages (p < 0.05). There was significant retraction of the upper lip in CS-3 (p = 0.001), protrusion of the lower lip in CS-2 (p = 0.005), increase in nasolabial angle in CS-4 (p = 0.006) and Z-angle in CS-3 (p = 0.016), reduction in H-angle in CS-2 (p = 0.013) and CS-3 (p = 0.002) groups. When pre- and post-treatment mean differences were compared between different cervical stages, significant differences were found for SNA, SNB and UI-SN angles and overjet. . The Twin-Block along with the normal craniofacial growth improves facial esthetics in Class II, Division 1 malocclusion by changes in underlying skeletal and dentoalveolar structures. The favorable mandibular growth occurs

Cephalometric evaluation of the effects of the Twin Block appliance in subjects with Class II, Division 1 malocclusion amongst different cervical vertebral maturation stages

PubMed Central

Khoja, Aisha; Fida, Mubassar; Shaikh, Attiya

2016-01-01

ABSTRACT Objectives: To evaluate the cephalometric changes in skeletal, dentoalveolar and soft tissue variables induced by Clark's Twin Block (CTB) in Class II, Division 1 malocclusion patients and to compare these changes in different cervical vertebral maturation stages. Methods: Pre- and post-treatment/observation lateral cephalograms of 53 Class II, Division 1 malocclusion patients and 60 controls were compared to evaluate skeletal, dentoalveolar and soft tissue changes. Skeletal maturity was assessed according to cervical vertebral maturation stages. Pre- and post-treatment/observation mean changes and differences (T2-T1) were compared by means of Wilcoxon sign rank and Mann-Whitney U-tests, respectively. Intergroup comparisons between different cervical stages were performed by means of Kruskal-Wallis test and Mann-Whitney U-test (p ≤ 0.05) . Results: When compared with controls, there was a significant reduction in ANB angle (p < 0.001), which was due to a change in SNB angle in CS-2 and CS-3 (p < 0.001), and in SNA (p < 0.001) and SNB (p = 0.016) angles in the CS-4 group. There was significant increase in the GoGn-SN angle in CS-2 (p = 0.007) and CS-4 (p = 0.024), and increase in Co-Gn and Go-Gn amongst all cervical stages (p < 0.05). There was significant decrease in U1-SN and increase in IMPA amongst all cervical stages (p < 0.05). There was significant retraction of the upper lip in CS-3 (p = 0.001), protrusion of the lower lip in CS-2 (p = 0.005), increase in nasolabial angle in CS-4 (p = 0.006) and Z-angle in CS-3 (p = 0.016), reduction in H-angle in CS-2 (p = 0.013) and CS-3 (p = 0.002) groups. When pre- and post-treatment mean differences were compared between different cervical stages, significant differences were found for SNA, SNB and UI-SN angles and overjet. . Conclusions: The Twin-Block along with the normal craniofacial growth improves facial esthetics in Class II, Division 1 malocclusion by changes in underlying skeletal and dentoalveolar

Epistaxis in end stage liver disease masquerading as severe upper gastrointestinal hemorrhage.

PubMed

Camus, Marine; Jensen, Dennis M; Matthews, Jason D; Ohning, Gordon V; Kovacs, Thomas O; Jutabha, Rome; Ghassemi, Kevin A; Machicado, Gustavo A; Dulai, Gareth S

2014-10-14

To describe the prevalence, diagnosis, treatment, and outcomes of end stage liver disease (ESLD) patients with severe epistaxis thought to be severe upper gastrointestinal hemorrhage (UGIH). This observational single center study included all consecutive patients with ESLD and epistaxis identified from consecutive subjects hospitalized with suspected UGIH and prospectively enrolled in our databases of severe UGIH between 1998 and 2011. A total of 1249 patients were registered for severe UGIH in the data basis, 461 (36.9%) were cirrhotics. Epistaxis rather than UGIH was the bleeding source in 20 patients. All patients had severe coagulopathy. Epistaxis was initially controlled in all cases. Fifteen (75%) subjects required posterior nasal packing and 2 (10%) embolization in addition to correction of coagulopathy. Five (25%) patients died in the hospital, 12 (60%) received orthotopic liver transplantation (OLT), and 3 (15%) were discharged without OLT. The mortality rate was 63% in patients without OLT. Severe epistaxis in patients with ESLD is (1) a diagnosis of exclusion that requires upper endoscopy to exclude severe UGIH; and (2) associated with a high mortality rate in patients not receiving OLT.

Preliminary Performance of Lithium-ion Cell Designs for Ares I Upper Stage Applications

NASA Technical Reports Server (NTRS)

Miller, Thomas B.; Reid, Concha M.; Kussmaul, Michael T.

2011-01-01

NASA's Ares I Crew Launch Vehicle (CLV) baselined lithium-ion technology for the Upper Stage (US). Under this effort, the NASA Glenn Research Center investigated three different aerospace lithium-ion cell suppliers to assess the performance of the various lithium-ion cell designs under acceptance and characterization testing. This paper describes the overall testing approaches associated with lithium-ion cells, their ampere-hour capacity as a function of temperature and discharge rates, as well as their performance limitations for use on the Ares I US vehicle.

SOX9 expression predicts relapse of stage II colon cancer patients.

PubMed

Marcker Espersen, Maiken Lise; Linnemann, Dorte; Christensen, Ib Jarle; Alamili, Mahdi; Troelsen, Jesper T; Høgdall, Estrid

2016-06-01

The aim of this study was to investigate if the protein expression of sex-determining region y-box 9 (SOX9) in primary tumors could predict relapse of stage II colon cancer patients. One hundred forty-four patients with stage II primary colon cancer were retrospectively enrolled in the study. SOX9 expression was evaluated by immunohistochemistry, and mismatch repair status was assessed by both immunohistochemistry and promoter hypermethylation assay. High SOX9 expression at the invasive front was significantly associated with lower risk of relapse when including the SOX9 expression as a continuous variable (from low to high expression) in univariate (hazard ratio [HR], 0.73; 95% confidence interval [CI], 0.56-0.94; P = .01) and multivariate Cox proportional hazards analyses (HR, 0.75; 95% CI, 0.58-0.96; P = .02), adjusting for mismatch repair deficiency and histopathologic risk factors. Conversely, low SOX9 expression at the invasive front was significantly associated with high risk of relapse, when including SOX9 expression as a dichotomous variable, in univariate (HR, 2.32; 95% CI, 1.14-4.69; P = .02) and multivariate analyses (HR, 2.32; 95% CI, 1.14-4.69; P = .02), adjusting for histopathologic risk factors and mismatch repair deficiency. In conclusion, high levels of SOX9 of primary stage II colon tumors predict low risk of relapse, whereas low levels of SOX9 predict high risk of relapse. SOX9 may have an important value as a biomarker when evaluating risk of relapse for personalized treatment. Copyright © 2016 Elsevier Inc. All rights reserved.

Design and Analysis of a Turbopump for a Conceptual Expander Cycle Upper-Stage Engine

NASA Technical Reports Server (NTRS)

Dorney, Daniel J.; Rothermel, Jeffry; Griffin, Lisa W.; Thornton, Randall J.; Forbes, John C.; Skelly, Stephen E.; Huber, Frank W.

2006-01-01

As part of the development of technologies for rocket engines that will power spacecraft to the Moon and Mars, a program was initiated to develop a conceptual upper stage engine with wide flow range capability. The resulting expander cycle engine design employs a radial turbine to allow higher pump speeds and efficiencies. In this paper, the design and analysis of the pump section of the engine are discussed. One-dimensional meanline analyses and three-dimensional unsteady computational fluid dynamics simulations were performed for the pump stage. Configurations with both vaneless and vaned diffusers were investigated. Both the meanline analysis and computational predictions show that the pump will meet the performance objectives. Additional details describing the development of a water flow facility test are also presented.

OCO-2-Delta II 2nd Stage Offload

NASA Image and Video Library

2014-02-24

VANDENBERG AIR FORCE BASE, Calif. – Workers prepare to lift the second stage for NASA's Orbiting Carbon Observatory-2 mission, or OCO-2, from its transportation trailer in the high bay of the Building 836 hangar on Vandenberg Air Force Base in California. OCO-2 is scheduled to launch aboard a United Launch Alliance Delta II rocket from Space Launch Complex 2 in July. The rocket's second stage will insert OCO-2 into a polar Earth orbit. OCO-2 will collect precise global measurements of carbon dioxide in the Earth's atmosphere and provide scientists with a better idea of the chemical compound's impacts on climate change. Scientists will analyze this data to improve our understanding of the natural processes and human activities that regulate the abundance and distribution of this important atmospheric gas. To learn more about OCO-2, visit http://oco.jpl.nasa.gov. Photo credit: NASA/Randy Beaudoin

OCO-2 - Delta II 2nd Stage Transport

NASA Image and Video Library

2014-02-24

VANDENBERG AIR FORCE BASE, Calif. – Workers push the second stage for NASA's Orbiting Carbon Observatory-2 mission, or OCO-2, toward the Horizontal Processing Facility at Space Launch Complex 2 on Vandenberg Air Force Base in California. OCO-2 is scheduled to launch aboard a United Launch Alliance Delta II rocket in July. The rocket's second stage will insert OCO-2 into a polar Earth orbit. OCO-2 will collect precise global measurements of carbon dioxide in the Earth's atmosphere and provide scientists with a better idea of the chemical compound's impacts on climate change. Scientists will analyze this data to improve our understanding of the natural processes and human activities that regulate the abundance and distribution of this important atmospheric gas. To learn more about OCO-2, visit http://oco.jpl.nasa.gov. Photo credit: NASA/Arron Tauman, 30th Space Wing, VAFB

INVESTIGATION OF BONE MINERALIZATION IN PATIENTS WITH CORONARY HEART DISEASE COMPLICATED BY CHRONIC HEART FAILURE, STAGE II-A.

PubMed

Krynytska, I; Marushchak, M; Zaets, T; Savchenko, I; Habor, H

2017-06-01

The majority of the studies have shown that individuals with cardiovascular diseases have a higher risk of experiencing bone loss and thus greater predisposition to risk of fracture. On the other hand there is growing evidence that individuals with low bone mass have higher mortality for cardiovascular events compared to patients with cardiovascular disease with normal bone mass. This research aims to investigate bone mineralization in patients with coronary heart disease complicated by stage II-A chronic heart failure. The study involved 33 men with coronary heart disease complicated by Stage II-A chronic heart failure. Bone mineral density was measured using dual energy x-ray densitometry of lumbar region of spine. Structural and functional changes of bone tissue of the lumbar spine have been found in 49,2% patients with coronary heart disease complicated by Stage II-A chronic heart failure, in particular, I stage of osteopenia - in 44,6%, II stage of osteopenia - in 27,7%, III stage of osteopenia - in 10,8% and osteoporosis - in 16,9%. It was established the same type of downward trend for BMD decreasing in L1 of patients with different stages of osteopenia, but in case of osteoporosis mineralization decreased equally in all vertebrae.

Anti-Carbonic Anhydrase II Antibodies in End-Stage Renal Disease Patients

PubMed Central

Alver, Ahmet; Menteşe, Ahmet; Menteşe, Ümit; Sümer, Ayşegül; Uçar, Fahri; Us Altay, Diler

2014-01-01

Objective The aim of this study was to investigate the presence of anti-carbonic anhydrase (CA II) autoantibodies in patients with end-stage renal disease (ESRD) and relationships between the autoantibody titers and ghrelin, glucose, blood urea nitrogen (BUN) and creatinine. Subjects and Methods Serum CA II autoantibody titers, malondialdehyde (MDA), BUN, creatinine and ghrelin levels were measured in 45 ESRD patients and 45 healthy subjects. Results The CA II autoantibody titers in the ESRD group (0.170 ± 0.237) were significantly higher than those in the control group (0.079 ± 0.032; p = 0.035). MDA and ghrelin levels were also significantly higher in the ESRD group (p < 0.001). A weak positive correlation was determined between anti-CA II antibody titers and MDA, and a negative correlation was observed between ghrelin levels and anti-CA II antibody titers (r = 0.287, p = 0.028 and r =b −0.278, p = 0.032, respectively). Conclusions In ESRD patients, the results showed the development of an autoimmune response against CA II. This suggests that anti-CA II antibodies could be involved in the pathogenesis of ESRD. PMID:24903210

Stir Friction Welding Used in Ares I Upper Stage Fabrication

NASA Technical Reports Server (NTRS)

2007-01-01

Under the goals of the Vision for Space Exploration, Ares I is a chief component of the cost-effective space transportation infrastructure being developed by NASA's Constellation Program. This transportation system will safely and reliably carry human explorers back to the moon, and then onward to Mars and other destinations in the solar system. The Ares I effort includes multiple project element teams at NASA centers and contract organizations around the nation, and is managed by the Exploration Launch Projects Office at NASA's Marshall Space Flight Center (MFSC). ATK Launch Systems near Brigham City, Utah, is the prime contractor for the first stage booster. ATK's subcontractor, United Space Alliance of Houston, is designing, developing and testing the parachutes at its facilities at NASA's Kennedy Space Center in Florida. NASA's Johnson Space Center in Houston hosts the Constellation Program and Orion Crew Capsule Project Office and provides test instrumentation and support personnel. Together, these teams are developing vehicle hardware, evolving proven technologies, and testing components and systems. Their work builds on powerful, reliable space shuttle propulsion elements and nearly a half-century of NASA space flight experience and technological advances. Ares I is an inline, two-stage rocket configuration topped by the Crew Exploration Vehicle, its service module, and a launch abort system. This HD video image depicts friction stir welding used in manufacturing aluminum panels that will fabricate the Ares I upper stage barrel. The panels are subjected to confidence tests in which the bent aluminum is stressed to breaking point and thoroughly examined. The panels are manufactured by AMRO Manufacturing located in El Monte, California. (Highest resolution available)

Stir Friction Welding Used in Ares I Upper Stage Fabrication

NASA Technical Reports Server (NTRS)

2007-01-01

Under the goals of the Vision for Space Exploration, Ares I is a chief component of the cost-effective space transportation infrastructure being developed by NASA's Constellation Program. This transportation system will safely and reliably carry human explorers back to the moon, and then onward to Mars and other destinations in the solar system. The Ares I effort includes multiple project element teams at NASA centers and contract organizations around the nation, and is managed by the Exploration Launch Projects Office at NASA's Marshall Space Flight Center (MFSC). ATK Launch Systems near Brigham City, Utah, is the prime contractor for the first stage booster. ATK's subcontractor, United Space Alliance of Houston, is designing, developing and testing the parachutes at its facilities at NASA's Kennedy Space Center in Florida. NASA's Johnson Space Center in Houston hosts the Constellation Program and Orion Crew Capsule Project Office and provides test instrumentation and support personnel. Together, these teams are developing vehicle hardware, evolving proven technologies, and testing components and systems. Their work builds on powerful, reliable space shuttle propulsion elements and nearly a half-century of NASA space flight experience and technological advances. Ares I is an inline, two-stage rocket configuration topped by the Crew Exploration Vehicle, its service module, and a launch abort system. This HD video image depicts friction stir welding used in manufacturing aluminum panels that will fabricate the Ares I upper stage barrel. The aluminum panels are subjected to confidence panel tests during which the bent aluminum is stressed to breaking point and thoroughly examined. The panels are manufactured by AMRO Manufacturing located in El Monte, California. (Highest resolution available)

Adjuvant 5FU plus levamisole in colonic or rectal cancer: improved survival in stage II and III

PubMed Central

Taal, B G; Van Tinteren, H; Zoetmulder, F A N

2001-01-01

Based on the first favourable results of adjuvant therapy of 5FU plus levamisole in Dukes C colonic cancer in 1990, we conducted a prospective trial. 1029 patients were randomised to receive one year 5FU plus levamisole or no further treatment following curative surgery for stage II or III colon (n = 730) or rectal cancer (n = 299). 45% were in stage II and 55% in stage III. With a median follow-up of 4 years and 9 months a significant reduction in odds of death (25%, SD 9%, P = 0.007) was observed for those with adjuvant treatment (65% at 5 year) compared to the observation group (55%). Improved relative survival was present in stage III (56% vs 44%), and in stage II patients (78% vs 70%). In rectal cancer a non-significant difference in disease-free or overall survival was observed. Distant metastases developed in 76%, while local recurrence alone occurred in 14%. An early start of adjuvant treatment (< 4 weeks) did not affect results. Compliance to 5FU plus levamisole was 69%. Severe toxicity did not occur. In conclusion, one year 5FU plus levamisole was of benefit in stage II and III colonic cancer; in rectal cancer a significant positive effect could not be demonstrated. © 2001 Cancer Research Campaign  http://www.bjcancer.com PMID:11720425

Mn(II) Oxidation by the Multicopper Oxidase Complex Mnx: A Coordinated Two-Stage Mn(II)/(III) and Mn(III)/(IV) Mechanism.

PubMed

Soldatova, Alexandra V; Romano, Christine A; Tao, Lizhi; Stich, Troy A; Casey, William H; Britt, R David; Tebo, Bradley M; Spiro, Thomas G

2017-08-23

The bacterial manganese oxidase MnxG of the Mnx protein complex is unique among multicopper oxidases (MCOs) in carrying out a two-electron metal oxidation, converting Mn(II) to MnO 2 nanoparticles. The reaction occurs in two stages: Mn(II) → Mn(III) and Mn(III) → MnO 2 . In a companion study , we show that the electron transfer from Mn(II) to the low-potential type 1 Cu of MnxG requires an activation step, likely forming a hydroxide bridge at a dinuclear Mn(II) site. Here we study the second oxidation step, using pyrophosphate (PP) as a Mn(III) trap. PP chelates Mn(III) produced by the enzyme and subsequently allows it to become a substrate for the second stage of the reaction. EPR spectroscopy confirms the presence of Mn(III) bound to the enzyme. The Mn(III) oxidation step does not involve direct electron transfer to the enzyme from Mn(III), which is shown by kinetic measurements to be excluded from the Mn(II) binding site. Instead, Mn(III) is proposed to disproportionate at an adjacent polynuclear site, thereby allowing indirect oxidation to Mn(IV) and recycling of Mn(II). PP plays a multifaceted role, slowing the reaction by complexing both Mn(II) and Mn(III) in solution, and also inhibiting catalysis, likely through binding at or near the active site. An overall mechanism for Mnx-catalyzed MnO 2 production from Mn(II) is presented.

Nivolumab After Combined Modality Therapy in Treating Patients With High Risk Stage II-IIIB Anal Cancer

ClinicalTrials.gov

2018-06-20

Anal Basaloid Carcinoma; Anal Canal Cloacogenic Carcinoma; Anal Margin Squamous Cell Carcinoma; Stage II Anal Canal Cancer AJCC v6 and v7; Stage IIB Anal Cancer AJCC v8; Stage III Anal Canal Cancer AJCC v6 and v7; Stage IIIA Anal Canal Cancer AJCC v6 and v7; Stage IIIB Anal Canal Cancer AJCC v6 and v7

Long-term Outcomes of One Stage Surgery Using Transanal Colorectal Tube for Acute Colorectal Obstruction of Stage II/III Distal Colon Cancer.

PubMed

Okuda, Yusuke; Yamada, Tomonori; Hirata, Yoshikazu; Shimura, Takaya; Yamaguchi, Ryuzo; Sakamoto, Eiji; Sobue, Satoshi; Nakazawa, Takahiro; Kataoka, Hiromi; Joh, Takashi

2018-06-06

Since oncological outcomes of transanal colorectal tube (TCT) placement, an endoscopic treatment for colorectal cancer (CRC) with acute colorectal obstruction (ACO), remain unknown, this study analyzed long-term outcomes of TCT placement for stage II/III CRC with ACO. Data were retrospectively reviewed from consecutive patients with distal stage II/III CRC who underwent surgery between January 2007 and December 2011 at two Japanese hospitals. One hospital conducted emergency surgery and the other performed TCT placement as the standard treatment for all CRCs with ACO. Propensity score (PS) matching was used to adjust baseline characteristics between two groups. Among 754 patients with distal stage II/III CRC, 680 did not have ACO (non-ACO group) and 74 had ACO (ACO group). The PS matching between both hospitals identified 234 pairs in the non-ACO group and 23 pairs in the ACO group. In the non-ACO group, the surgical quality was equivalent between the two institutions, with no significant differences in overall survival (OS) and disease-free survival (DFS). In the ACO group, the rate of primary resection/anastomosis was higher in the TCT group than in the surgery group (87.0% vs. 26.1%; p < 0.001). No significant differences were noted between the surgery and the TCT groups in OS (5-year OS, 61.9% vs. 51.5%; p=0.490) and DFS (5-year DFS, 45.9% vs. 38.3%; p=0.658). TCT placement can achieve similar long-term outcomes to emergency surgery, with a high rate of primary resection/anastomosis for distal stage II/III colon cancer with ACO.

OCO-2 - Delta II 2nd Stage Offload

NASA Image and Video Library

2014-02-24

VANDENBERG AIR FORCE BASE, Calif. – As the cover of the transportation trailer is lifted in the high bay of the Building 836 hangar on Vandenberg Air Force Base in California, the second stage for NASA's Orbiting Carbon Observatory-2 mission, or OCO-2, comes into view. OCO-2 is scheduled to launch aboard a United Launch Alliance Delta II rocket from Space Launch Complex 2 in July. The rocket's second stage will insert OCO-2 into a polar Earth orbit. OCO-2 will collect precise global measurements of carbon dioxide in the Earth's atmosphere and provide scientists with a better idea of the chemical compound's impacts on climate change. Scientists will analyze this data to improve our understanding of the natural processes and human activities that regulate the abundance and distribution of this important atmospheric gas. To learn more about OCO-2, visit http://oco.jpl.nasa.gov. Photo credit: NASA/Arron Tauman, 30th Space Wing, VAFB

The Effect of Simvastatin on Breast Cancer Cell Growth in Women With Stage I-II Breast Cancer

ClinicalTrials.gov

2018-03-02

Invasive Breast Carcinoma; Stage I Breast Cancer AJCC v7; Stage IA Breast Cancer AJCC v7; Stage IB Breast Cancer AJCC v7; Stage II Breast Cancer AJCC v6 and v7; Stage IIA Breast Cancer AJCC v6 and v7; Stage IIB Breast Cancer AJCC v6 and v7

Large-Scale Liquid Hydrogen Tank Rapid Chill and Fill Testing for the Advanced Shuttle Upper Stage Concept

NASA Technical Reports Server (NTRS)

Flachbart, R. H.; Hedayat, A.; Holt, K. A.; Sims, J.; Johnson, E. F.; Hastings, L. J.; Lak, T.

2013-01-01

Cryogenic upper stages in the Space Shuttle program were prohibited primarily due to a safety risk of a 'return to launch site' abort. An upper stage concept addressed this concern by proposing that the stage be launched empty and filled using shuttle external tank residuals after the atmospheric pressure could no longer sustain an explosion. However, only about 5 minutes was allowed for tank fill. Liquid hydrogen testing was conducted within a near-ambient environment using the multipurpose hydrogen test bed 638.5 ft3 (18m3) cylindrical tank with a spray bar mounted longitudinally inside. Although the tank was filled within 5 minutes, chilldown of the tank structure was incomplete, and excessive tank pressures occurred upon vent valve closure. Elevated tank wall temperatures below the liquid level were clearly characteristic of film boiling. The test results have substantial implications for on-orbit cryogen transfer since the formation of a vapor film would be much less inhibited due to the reduced gravity. However, the heavy tank walls could become an asset in normal gravity testing for on-orbit transfer, i.e., if film boiling in a nonflight weight tank can be inhibited in normal gravity, then analytical modeling anchored with the data could be applied to reduced gravity environments with increased confidence.

Delta II JPSS-1 First Stage Transport to SLC-1 for Processing

NASA Image and Video Library

2016-04-05

The first stage of United Launch Alliance Delta II rocket for the Joint Polar Satellite System, or JPSS-1, is transported from NASA Hangar 836 to the Horizontal Processing Facility, located at Vandenberg Air Force Base in California.

Epistaxis in end stage liver disease masquerading as severe upper gastrointestinal hemorrhage

PubMed Central

Camus, Marine; Jensen, Dennis M; Matthews, Jason D; Ohning, Gordon V; Kovacs, Thomas O; Jutabha, Rome; Ghassemi, Kevin A; Machicado, Gustavo A; Dulai, Gareth S

2014-01-01

AIM: To describe the prevalence, diagnosis, treatment, and outcomes of end stage liver disease (ESLD) patients with severe epistaxis thought to be severe upper gastrointestinal hemorrhage (UGIH). METHODS: This observational single center study included all consecutive patients with ESLD and epistaxis identified from consecutive subjects hospitalized with suspected UGIH and prospectively enrolled in our databases of severe UGIH between 1998 and 2011. RESULTS: A total of 1249 patients were registered for severe UGIH in the data basis, 461 (36.9%) were cirrhotics. Epistaxis rather than UGIH was the bleeding source in 20 patients. All patients had severe coagulopathy. Epistaxis was initially controlled in all cases. Fifteen (75%) subjects required posterior nasal packing and 2 (10%) embolization in addition to correction of coagulopathy. Five (25%) patients died in the hospital, 12 (60%) received orthotopic liver transplantation (OLT), and 3 (15%) were discharged without OLT. The mortality rate was 63% in patients without OLT. CONCLUSION: Severe epistaxis in patients with ESLD is (1) a diagnosis of exclusion that requires upper endoscopy to exclude severe UGIH; and (2) associated with a high mortality rate in patients not receiving OLT. PMID:25320538

Brentuximab Vedotin and Combination Chemotherapy in Treating Older Patients With Previously Untreated Stage II-IV Hodgkin Lymphoma

ClinicalTrials.gov

2018-02-01

Adult Lymphocyte Depletion Hodgkin Lymphoma; Adult Lymphocyte Predominant Hodgkin Lymphoma; Adult Mixed Cellularity Hodgkin Lymphoma; Adult Nodular Sclerosis Hodgkin Lymphoma; Stage II Adult Hodgkin Lymphoma; Stage III Adult Hodgkin Lymphoma; Stage IV Adult Hodgkin Lymphoma

Prognostic impact of interhospital variation in adjuvant chemotherapy for patients with Stage II/III colorectal cancer: a nationwide study.

PubMed

Arakawa, K; Kawai, K; Tanaka, T; Hata, K; Sugihara, K; Nozawa, H

2018-05-12

Clinical guidelines recommend adjuvant chemotherapy for high-risk patients with Stage II-III colorectal cancer. However, chemotherapeutic administration rates differ significantly between hospitals. We assessed the prognostic benefit of adjuvant chemotherapy in patients with Stage IIb/c colorectal cancer, and the prognostic impact of interhospital variations in the administration of adjuvant chemotherapy for Stage II-III colorectal cancer. We conducted a multicentre, retrospective study of 17 757 patients with Stage II-III colorectal cancer treated between 1997 and 2008 in 23 hospitals in Japan. Hospitals were classified as high-rate (rate > 42.8%) or low-rate (rate ≤ 42.8%), chemotherapy prescribing clinics. The 5-year overall survival (OS) of patients with Stage II-III colorectal cancer receiving adjuvant chemotherapy was significantly higher than for those not receiving adjuvant chemotherapy (85.7% vs 79.2%, P < 0.01 and 79.9% vs 72.5%, P < 0.01, respectively). For patients with Stage II disease, adjuvant chemotherapy was an independent factor for longer OS (P < 0.01, hazard ratio = 0.71). Both adjuvant chemotherapy and high-rate hospital independently improved OS for patients with Stage III colorectal cancer (both P < 0.01; hazard ratio = 0.68 and 0.87, respectively). Significant prognostic benefit was found for patients with Stage IIb/c colorectal cancer who received adjuvant chemotherapy, with patients who were treated in hospitals with high adjuvant chemotherapy rates demonstrating better prognoses. Colorectal Disease © 2018 The Association of Coloproctology of Great Britain and Ireland.

Stir Friction Welding Used in Ares I Upper Stage Fabrication

NASA Technical Reports Server (NTRS)

2007-01-01

Under the goals of the Vision for Space Exploration, Ares I is a chief component of the cost-effective space transportation infrastructure being developed by NASA's Constellation Program. This transportation system will safely and reliably carry human explorers back to the moon, and then onward to Mars and other destinations in the solar system. The Ares I effort includes multiple project element teams at NASA centers and contract organizations around the nation, and is managed by the Exploration Launch Projects Office at NASA's Marshall Space Flight Center (MFSC). ATK Launch Systems near Brigham City, Utah, is the prime contractor for the first stage booster. ATK's subcontractor, United Space Alliance of Houston, is designing, developing and testing the parachutes at its facilities at NASA's Kennedy Space Center in Florida. NASA's Johnson Space Center in Houston hosts the Constellation Program and Orion Crew Capsule Project Office and provides test instrumentation and support personnel. Together, these teams are developing vehicle hardware, evolving proven technologies, and testing components and systems. Their work builds on powerful, reliable space shuttle propulsion elements and nearly a half-century of NASA space flight experience and technological advances. Ares I is an inline, two-stage rocket configuration topped by the Crew Exploration Vehicle, its service module, and a launch abort system. This HD video image depicts the preparation and placement of a confidence ring for friction stir welding used in manufacturing aluminum panels that will fabricate the Ares I upper stage barrel. The aluminum panels are manufactured and subjected to confidence tests during which the bent aluminum is stressed to breaking point and thoroughly examined. The panels are manufactured by AMRO Manufacturing located in El Monte, California. (Highest resolution available)

Ares I-X Upper Stage Simulator Compartment Pressure Comparisons During Ascent

NASA Technical Reports Server (NTRS)

Downs. William J.; Kirchner, Robert D.; McLachlan, Blair G.; Hand, Lawrence A.; Nelson, Stuart L.

2011-01-01

Predictions of internal compartment pressures are necessary in the design of interstage regions, systems tunnels, and protuberance covers of launch vehicles to assess potential burst and crush loading of the structure. History has proven that unexpected differential pressure loads can lead to catastrophic failure. Pressures measured in the Upper Stage Simulator (USS) compartment of Ares I-X during flight were compared to post-flight analytical predictions using the CHCHVENT chamber-to-chamber venting analysis computer program. The measured pressures were enveloped by the analytical predictions for most of the first minute of flight but were outside of the predictions thereafter. This paper summarizes the venting system for the USS, discusses the probable reasons for the discrepancies between the measured and predicted pressures, and provides recommendations for future flight vehicles.

2-Hexadecynoic acid inhibits plasmodial FAS-II enzymes and arrests erythrocytic and liver stage Plasmodium infections.

PubMed

Tasdemir, Deniz; Sanabria, David; Lauinger, Ina L; Tarun, Alice; Herman, Rob; Perozzo, Remo; Zloh, Mire; Kappe, Stefan H; Brun, Reto; Carballeira, Néstor M

2010-11-01

Acetylenic fatty acids are known to display several biological activities, but their antimalarial activity has remained unexplored. In this study, we synthesized the 2-, 5-, 6-, and 9-hexadecynoic acids (HDAs) and evaluated their in vitro activity against erythrocytic (blood) stages of Plasmodium falciparum and liver stages of Plasmodium yoelii infections. Since the type II fatty acid biosynthesis pathway (PfFAS-II) has recently been shown to be indispensable for liver stage malaria parasites, the inhibitory potential of the HDAs against multiple P. falciparum FAS-II (PfFAS-II) elongation enzymes was also evaluated. The highest antiplasmodial activity against blood stages of P. falciparum was displayed by 5-HDA (IC(50) value 6.6 μg/ml), whereas the 2-HDA was the only acid arresting the growth of liver stage P. yoelii infection, in both flow cytometric assay (IC(50) value 2-HDA 15.3 μg/ml, control drug atovaquone 2.5 ng/ml) and immunofluorescence analysis (IC(50) 2-HDA 4.88 μg/ml, control drug atovaquone 0.37 ng/ml). 2-HDA showed the best inhibitory activity against the PfFAS-II enzymes PfFabI and PfFabZ with IC(50) values of 0.38 and 0.58 μg/ml (IC(50) control drugs 14 and 30 ng/ml), respectively. Enzyme kinetics and molecular modeling studies revealed valuable insights into the binding mechanism of 2-HDA on the target enzymes. All HDAs showed in vitro activity against Trypanosoma brucei rhodesiense (IC(50) values 3.7-31.7 μg/ml), Trypanosoma cruzi (only 2-HDA, IC(50) 20.2 μg/ml), and Leishmania donovani (IC(50) values 4.1-13.4 μg/ml) with generally low or no significant toxicity on mammalian cells. This is the first study to indicate therapeutic potential of HDAs against various parasitic protozoa. It also points out that the malarial liver stage growth inhibitory effect of the 2-HDA may be promoted via PfFAS-II enzymes. The lack of cytotoxicity, lipophilic nature, and calculated pharmacokinetic properties suggests that 2-HDA could be a useful compound to

2-Hexadecynoic Acid Inhibits Plasmodial FAS-II Enzymes and Arrest Erythrocytic and Liver Stage Plasmodium Infections

PubMed Central

Tasdemir, Deniz; Sanabria, David; Lauinger, Ina L.; Tarun, Alice; Herman, Rob; Perozzo, Remo; Zloh, Mire; Kappe, Stefan H.; Brun, Reto; Carballeira, Néstor M.

2010-01-01

Acetylenic fatty acids are known to display several biological activities, but their antimalarial activity has remained unexplored. In this study, we synthesized the 2-, 5-, 6-, and 9-hexadecynoic acids (HDAs) and evaluated their in vitro activity against erythrocytic (blood) stages of Plasmodium falciparum and liver stages of P. yoelii infections. Since the type II fatty acid biosynthesis pathway (PfFAS-II) has recently been shown to be indispensable for liver stage malaria parasites, the inhibitory potential of the HDAs against multiple P. falciparum FAS-II (PfFAS-II) elongation enzymes was also evaluated. The highest antiplasmodial activity against blood stages of P. falciparum was displayed by 5-HDA (IC50 value 6.6. μg/ml), whereas the 2-HDA was the only acid arresting the growth of liver stage P. yoelii infection, in both flow cytometric assay (IC50 value 2-HDA 15.3 μg/ml, control drug atovaquone 2.5 ng/ml) and immunofluorescense analysis (IC50 2-HDA 4.88 μg/ml, control drug atovaquone 0.37 ng/ml). 2-HDA showed the best inhibitory against the PfFAS-II enzymes PfFabI and PfFabZ with IC50 values of 0.38 and 0.58 μg/ml (IC50 control drugs 14 and 30 ng/ml) respectively. Enzyme kinetics and molecular modeling studies revealed valuable insights into the binding mechanism of 2-HDA on the target enzymes. All HDAs showed in vitro activity against Trypanosoma brucei rhodesiense (IC50 values 3.7–31.7 μg/ml), Trypanosoma cruzi (only 2-HDA, IC50 20.2 μg/ml), and Leishmania donovani (IC50 values 4.1–13.4 μg/ml) with generally low or no significant toxicity on mammalian cells. This is the first study to indicate therapeutic potential of HDAs against various parasitic protozoa. It also points out that the malarial liver stage growth inhibitory effect of the 2-HDA may be promoted via PfFAS-II enzymes. The lack of cytotoxicity, lipophilic nature and calculated pharmacokinetic properties suggest that 2-HDA could be a useful compound to study the interaction of fatty

Identification and Construction of Combinatory Cancer Hallmark-Based Gene Signature Sets to Predict Recurrence and Chemotherapy Benefit in Stage II Colorectal Cancer.

PubMed

Gao, Shanwu; Tibiche, Chabane; Zou, Jinfeng; Zaman, Naif; Trifiro, Mark; O'Connor-McCourt, Maureen; Wang, Edwin

2016-01-01

Decisions regarding adjuvant therapy in patients with stage II colorectal cancer (CRC) have been among the most challenging and controversial in oncology over the past 20 years. To develop robust combinatory cancer hallmark-based gene signature sets (CSS sets) that more accurately predict prognosis and identify a subset of patients with stage II CRC who could gain survival benefits from adjuvant chemotherapy. Thirteen retrospective studies of patients with stage II CRC who had clinical follow-up and adjuvant chemotherapy were analyzed. Respective totals of 162 and 843 patients from 2 and 11 independent cohorts were used as the discovery and validation cohorts, respectively. A total of 1005 patients with stage II CRC were included in the 13 cohorts. Among them, 84 of 416 patients in 3 independent cohorts received fluorouracil-based adjuvant chemotherapy. Identification of CSS sets to predict relapse-free survival and identify a subset of patients with stage II CRC who could gain substantial survival benefits from fluorouracil-based adjuvant chemotherapy. Eight cancer hallmark-based gene signatures (30 genes each) were identified and used to construct CSS sets for determining prognosis. The CSS sets were validated in 11 independent cohorts of 767 patients with stage II CRC who did not receive adjuvant chemotherapy. The CSS sets accurately stratified patients into low-, intermediate-, and high-risk groups. Five-year relapse-free survival rates were 94%, 78%, and 45%, respectively, representing 60%, 28%, and 12% of patients with stage II disease. The 416 patients with CSS set-defined high-risk stage II CRC who received fluorouracil-based adjuvant chemotherapy showed a substantial gain in survival benefits from the treatment (ie, recurrence reduced by 30%-40% in 5 years). The CSS sets substantially outperformed other prognostic predictors of stage 2 CRC. They are more accurate and robust for prognostic predictions and facilitate the identification of patients with stage

Seal Joint Analysis and Design for the Ares-I Upper Stage LOX Tank

NASA Technical Reports Server (NTRS)

Phillips, Dawn R.; Wingate, Robert J.

2011-01-01

The sealing capability of the Ares-I Upper Stage liquid oxygen tank-to-sump joint is assessed by analyzing the deflections of the joint components. Analyses are performed using three-dimensional symmetric wedge finite element models and the ABAQUS commercial finite element software. For the pressure loads and feedline interface loads, the analyses employ a mixed factor of safety approach to comply with the Constellation Program factor of safety requirements. Naflex pressure-assisted seals are considered first because they have been used successfully in similar seal joints in the Space Shuttle External Tank. For the baseline sump seal joint configuration with a Naflex seal, the predicted joint opening greatly exceeds the seal design specification. Three redesign options of the joint that maintain the use of a Naflex seal are studied. The joint openings for the redesigned seal joints show improvement over the baseline configuration; however, these joint openings still exceed the seal design specification. RACO pressure-assisted seals are considered next because they are known to also be used on the Space Shuttle External Tank, and the joint opening allowable is much larger than the specification for the Naflex seals. The finite element models for the RACO seal analyses are created by modifying the models that were used for the Naflex seal analyses. The analyses show that the RACO seal may provide sufficient sealing capability for the sump seal joint. The results provide reasonable data to recommend the design change and plan a testing program to determine the capability of RACO seals in the Ares-I Upper Stage liquid oxygen tank sump seal joint.

Art concept of Magellan spacecraft and inertial upper stage (IUS) deployment

NASA Technical Reports Server (NTRS)

1988-01-01

Magellan spacecraft mounted on inertial upper stage drifts above Atlantis, Orbiter Vehicle (OV) 104, after its deployment during mission STS-30 in this artist concept. Solar panels are deployed and in OV-104's open payload bay (PLB) the airborne support equipment (ASE) is visible. Both spacecraft are orbiting the Earth. Magellan, named after the 16th century Portuguese explorer, will orbit Venus about once every three hours, acquiring radar data for 37 minutes of each orbit when it is closest to the surface. Using an advanced instrument called a synthetic aperture radar (SAR), it will map more than 90 per cent of the surface with resolution ten times better than the best from prior spacecraft. Magellan is managed by the Jet Propulsion Laboratory (JPL); Martin Marietta Aerospace is developing the spacecraft and Hughes Aircraft Company, the advanced imaging radar.

Upper gastrointestinal bleeding in patients with CKD.

PubMed

Liang, Chih-Chia; Wang, Su-Ming; Kuo, Huey-Liang; Chang, Chiz-Tzung; Liu, Jiung-Hsiun; Lin, Hsin-Hung; Wang, I-Kuan; Yang, Ya-Fei; Lu, Yueh-Ju; Chou, Che-Yi; Huang, Chiu-Ching

2014-08-07

Patients with CKD receiving maintenance dialysis are at risk for upper gastrointestinal bleeding. However, the risk of upper gastrointestinal bleeding in patients with early CKD who are not receiving dialysis is unknown. The hypothesis was that their risk of upper gastrointestinal bleeding is negatively linked to renal function. To test this hypothesis, the association between eGFR and risk of upper gastrointestinal bleeding in patients with stages 3-5 CKD who were not receiving dialysis was analyzed. Patients with stages 3-5 CKD in the CKD program from 2003 to 2009 were enrolled and prospectively followed until December of 2012 to monitor the development of upper gastrointestinal bleeding. The risk of upper gastrointestinal bleeding was analyzed using competing-risks regression with time-varying covariates. In total, 2968 patients with stages 3-5 CKD who were not receiving dialysis were followed for a median of 1.9 years. The incidence of upper gastrointestinal bleeding per 100 patient-years was 3.7 (95% confidence interval, 3.5 to 3.9) in patients with stage 3 CKD, 5.0 (95% confidence interval, 4.8 to 5.3) in patients with stage 4 CKD, and 13.9 (95% confidence interval, 13.1 to 14.8) in patients with stage 5 CKD. Higher eGFR was associated with a lower risk of upper gastrointestinal bleeding (P=0.03), with a subdistribution hazard ratio of 0.93 (95% confidence interval, 0.87 to 0.99) for every 5 ml/min per 1.73 m(2) higher eGFR. A history of upper gastrointestinal bleeding (P<0.001) and lower serum albumin (P=0.004) were independently associated with higher upper gastrointestinal bleeding risk. In patients with CKD who are not receiving dialysis, lower renal function is associated with higher risk for upper gastrointestinal bleeding. The risk is higher in patients with previous upper gastrointestinal bleeding history and low serum albumin. Copyright © 2014 by the American Society of Nephrology.

Camera Layout Design for the Upper Stage Thrust Cone

NASA Technical Reports Server (NTRS)

Wooten, Tevin; Fowler, Bart

2010-01-01

Engineers in the Integrated Design and Analysis Division (EV30) use a variety of different tools to aid in the design and analysis of the Ares I vehicle. One primary tool in use is Pro-Engineer. Pro-Engineer is a computer-aided design (CAD) software that allows designers to create computer generated structural models of vehicle structures. For the Upper State thrust cone, Pro-Engineer was used to assist in the design of a layout for two camera housings. These cameras observe the separation between the first and second stage of the Ares I vehicle. For the Ares I-X, one standard speed camera was used. The Ares I design calls for two separate housings, three cameras, and a lighting system. With previous design concepts and verification strategies in mind, a new layout for the two camera design concept was developed with members of the EV32 team. With the new design, Pro-Engineer was used to draw the layout to observe how the two camera housings fit with the thrust cone assembly. Future analysis of the camera housing design will verify the stability and clearance of the camera with other hardware present on the thrust cone.

Additively Manufactured Low Cost Upper Stage Combustion Chamber

NASA Technical Reports Server (NTRS)

Protz, Christopher; Cooper, Ken; Ellis, David; Fikes, John; Jones, Zachary; Kim, Tony; Medina, Cory; Taminger, Karen; Willingham, Derek

2016-01-01

Over the past two years NASA's Low Cost Upper Stage Propulsion (LCUSP) project has developed Additive Manufacturing (AM) technologies and design tools aimed at reducing the costs and manufacturing time of regeneratively cooled rocket engine components. High pressure/high temperature combustion chambers and nozzles must be regeneratively cooled to survive their operating environment, causing their design fabrication to be costly and time consuming due to the number of individual steps and different processes required. Under LCUSP, AM technologies in Sintered Laser Melting (SLM) GRCop-84 and Electron Beam Freeform Fabrication (EBF3) Inconel 625 have been significantly advanced, allowing the team to successfully fabricate a 25k-class regenerative chamber. Estimates of the costs and schedule of future builds indicate cost reductions and significant schedule reductions will be enabled by this technology. Characterization of the microstructural and mechanical properties of the SLM-produced GRCop-84, EBF3 Inconel 625 and the interface layer between the two has been performed and indicates the properties will meet the design requirements. The LCUSP chamber is to be tested with a previously demonstrated SLM injector in order to advance the Technology Readiness Level (TRL) and demonstrate the capability of the application of these processes. NASA is advancing these technologies to reduce cost and schedule for future engine applications and commercial needs.

Solar Thermal Upper Stage Liquid Hydrogen Pressure Control Testing and Analytical Modeling

NASA Technical Reports Server (NTRS)

Olsen, A. D.; Cady, E. C.; Jenkins, D. S.; Chandler, F. O.; Grayson, G. D.; Lopez, A.; Hastings, L. J.; Flachbart, R. H.; Pedersen, K. W.

2012-01-01

The demonstration of a unique liquid hydrogen (LH2) storage and feed system concept for solar thermal upper stage was cooperatively accomplished by a Boeing/NASA Marshall Space Flight Center team. The strategy was to balance thermodynamic venting with the engine thrusting timeline during a representative 30-day mission, thereby, assuring no vent losses. Using a 2 cubic m (71 cubic ft) LH2 tank, proof-of-concept testing consisted of an engineering checkout followed by a 30-day mission simulation. The data were used to anchor a combination of standard analyses and computational fluid dynamics (CFD) modeling. Dependence on orbital testing has been incrementally reduced as CFD codes, combined with standard modeling, continue to be challenged with test data such as this.

Delta II Geotail -- 1st Stage and Solid Motor Booster Erection

NASA Technical Reports Server (NTRS)

1992-01-01

The Geotail mission's goal was to investigate the structure and dynamics of the geomagnetic tail that extends on the nightside of the Earth. The launch date was July 24, 1992. This video shows the Delta II on the pad, being prepared for the launch. The first stage and the solid motor booster are shown being moved into place on the rocket.

Phase II Study of Chemoradiotherapy With 5-Fluorouracil and Cisplatin for Stage II-III Esophageal Squamous Cell Carcinoma: JCOG Trial (JCOG 9906)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kato, Ken, E-mail: kenkato@ncc.go.jp; Muro, Kei; Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya, Aichi

Purpose: In this Phase II study, we evaluated the efficacy and toxicity of chemoradiotherapy (CRT) with cisplatin (CDDP) and 5-fluorouracil (5-FU) for Stage II-III esophageal squamous cell carcinoma (ESCC). Patients and Methods: Patients with clinical Stage II-III (T1N1M0 or T2-3N0-1M0) thoracic ESCC were enrolled between April 2000 and March 2002. Chemotherapy comprised two courses of protracted infusion of 5-FU (400 mg/m{sup 2}/day) on Days 1-5 and 8-12, and 2-h infusion of CDDP (40 mg/m{sup 2}) on Days 1 and 8; this regimen was repeated every 5 weeks. Concurrent radiotherapy involved 60-Gy irradiation (30 fractions) for 8 weeks with a 2-weekmore » break. Responders received two courses of 5-FU (800 mg/m{sup 2}/day) on Days 1-5 and CDDP (80 mg/m{sup 2}) on Day 1. Final analysis was conducted in March 2007. Survival and late toxicities were monitored for 5 years. Results: The characteristics of the 76 patients enrolled were as follows: median age, 61 years; male/female, 68/8; performance status 0/1, 59/17 patients; Stage IIA/IIB/III, 26/12/38 patients. Of the 74 eligible patients, 46 (62.2%) achieved complete response. Median survival time was 29 months, with 3- and 5-year survival rates of 44.7% and 36.8%, respectively. Acute toxicities included Grade 3/4 esophagitis (17%), nausea (17%), hyponatremia (16%), and infection without neutropenia (12%). Late toxicities comprised Grade 3/4 esophagitis (13%), pericardial (16%) and pleural (9%) effusion, and radiation pneumonitis (4%), causing 4 deaths. Conclusions: CRT is effective for Stage II-III ESCC with manageable acute toxicities and can provide a nonsurgical treatment option. However, further improvement is required for reduction in late toxicity.« less

Alternative Dosing of Exemestane Before Surgery in Treating Postmenopausal Patients With Stage 0-II Estrogen Positive Breast Cancer

ClinicalTrials.gov

2018-04-09

Estrogen Receptor Positive; Postmenopausal; Stage 0 Breast Cancer AJCC v6 and v7; Stage I Breast Cancer AJCC v7; Stage IA Breast Cancer AJCC v7; Stage IB Breast Cancer AJCC v7; Stage II Breast Cancer AJCC v6 and v7; Stage IIA Breast Cancer AJCC v6 and v7; Stage IIB Breast Cancer AJCC v6 and v7

Association of Adjuvant Chemotherapy With Survival in Patients With Stage II or III Gastric Cancer

PubMed Central

Jiang, Yuming; Li, Tuanjie; Liang, Xiaoling; Hu, Yanfeng; Huang, Lei; Liao, Zhenchen; Zhao, Liying; Han, Zhen; Zhu, Shuguang; Wang, Menglan; Xu, Yangwei; Qi, Xiaolong; Liu, Hao; Yang, Yang; Yu, Jiang; Liu, Wei; Cai, Shirong

2017-01-01

Importance The current staging system of gastric cancer is not adequate for defining a prognosis and predicting the patients most likely to benefit from chemotherapy. Objective To construct a survival prediction model based on specific tumor and patient characteristics that enables individualized predictions of the net survival benefit of adjuvant chemotherapy for patients with stage II or stage III gastric cancer. Design, Setting, and Participants In this multicenter retrospective analysis, a survival prediction model was constructed using data from a training cohort of 746 patients with stage II or stage III gastric cancer who satisfied the study’s inclusion criteria and underwent surgery between January 1, 2004, and December 31, 2012, at Nanfang Hospital in Guangzhou, China. Patient and tumor characteristics were included as covariates, and their association with overall survival and disease-free survival with and without adjuvant chemotherapy was assessed. The model was internally validated for discrimination and calibration using bootstrap resampling. To externally validate the model, data were included from a validation cohort of 973 patients with stage II or stage III gastric cancer who met the inclusion criteria and underwent surgery at First Affiliated Hospital in Guangzhou, China, and at West China Hospital of Sichuan Hospital in Chendu, China, between January 1, 2000, and June 30, 2009. Data were analyzed from July 10, 2016, to September 1, 2016. Main Outcomes and Measures Concordance index and decision curve analysis for each measure associated with postoperative overall survival and disease-free survival. Results Of the 1719 patients analyzed, 1183 (68.8%) were men and 536 (31.2%) were women and the median (interquartile range) age was 57 (49-66) years. Age, location, differentiation, carcinoembryonic antigen, cancer antigen 19-9, depth of invasion, lymph node metastasis, and adjuvant chemotherapy were significantly associated with overall survival

Postoperative radiotherapy and tumor recurrence after complete resection of stage II/III thymic tumor: a meta-analysis of cohort studies.

PubMed

Ma, Jietao; Sun, Xin; Huang, Letian; Xiong, Zhicheng; Yuan, Meng; Zhang, Shuling; Han, Cheng-Bo

2016-01-01

Whether postoperative radiotherapy (PORT) is effective for reducing the recurrence risk in patients who received complete resection of the stage II or III thymic tumors has not been determined. A meta-analysis was performed by combining the results of all available controlled trials. PubMed, Cochrane's Library, and the Embase databases were searched for studies which compared the recurrence data for patients with complete resection of the stage II or III thymic tumors assigned to an observing group, or a PORT group. A random effect model was applied to combine the results. Nineteen studies, all designed as retrospective cohort studies were included. These studies included 663 patients of PORT group and 617 patients of observing group. The recurrence rate for the patients in PORT group and observing group were 12.4% and 11.5%, respectively. Results of our study indicated that PORT has no significant influence on recurrent risk in patients with stage II or III thymic tumor after complete resection (odds ratio 1.02, 95% confidence interval 0.55-1.90, P=0.96). When stratified by stages, our meta-analyses did not indicate any significant effects of PORT on recurrent outcomes in either the stage II or the stage III patients. Moreover, subsequent analysis limited to studies only including patients with thymoma or thymic carcinoma also did not support the benefits of PORT on recurrent outcomes. Although derived from retrospective cohort studies, current evidence did not support any benefit of PORT on recurrent risk in patients with complete resection of the stage II or III thymic tumors.

Chemical layering in the upper mantle of Mars: Evidence from olivine-hosted melt inclusions in Tissint

NASA Astrophysics Data System (ADS)

Basu Sarbadhikari, A.; Babu, E. V. S. S. K.; Vijaya Kumar, T.

2017-02-01

Melting of Martian mantle, formation, and evolution of primary magma from the depleted mantle were previously modeled from experimental petrology and geochemical studies of Martian meteorites. Based on in situ major and trace element study of a range of olivine-hosted melt inclusions in various stages of crystallization of Tissint, a depleted olivine-phyric shergottite, we further constrain different stages of depletion and enrichment in the depleted mantle source of the shergottite suite. Two types of melt inclusions were petrographically recognized. Type I melt inclusions occur in the megacrystic olivine core (Fo76-70), while type II melt inclusions are hosted by the outer mantle of the olivine (Fo66-55). REE-plot indicates type I melt inclusions, which are unique because they represent the most depleted trace element data from the parent magmas of all the depleted shergottites, are an order of magnitude depleted compared to the type II melt inclusions. The absolute REE content of type II displays parallel trend but somewhat lower value than the Tissint whole-rock. Model calculations indicate two-stage mantle melting events followed by enrichment through mixing with a hypothetical residual melt from solidifying magma ocean. This resulted in 10 times enrichment of incompatible trace elements from parent magma stage to the remaining melt after 45% crystallization, simulating the whole-rock of Tissint. We rule out any assimilation due to crustal recycling into the upper mantle, as proposed by a recent study. Rather, we propose the presence of Al, Ca, Na, P, and REE-rich layer at the shallower upper mantle above the depleted mantle source region during the geologic evolution of Mars.

Fe-As sludge stability and effluent quality for a two-stage As-contaminated water treatment with Fe(II) and aeration.

PubMed

Zhuang, J Ming; Hobenshield, Evan; Walsh, Tony

2009-02-01

A two-stage (I and II) lab-scale treatment system has been studied for arsenic removal from water using Fe(II) and lignosulphonates with aeration. In stage I, using an Fe/As mole ratio of 1.5-2.5 at a pH of around 6.5-7.5, the dissolved arsenic can be reduced with Fe(II) oxidation-precipitation from an initial 72 mg L(-1) to < 2 mg L(-1). The generated sludge is entirely recycled to the second tank of stage II. In the first tank of stage II, the water is further treated with the same amount of Fe(II) as that used in stage I, in the presence of lignosulphonates and aeration. The air-oxidization of Fe(II) to Fe(III) is continued for about 30 minutes at a pH of around 7.0-8.0. The water output from the first tank is transferred to the second tank in which mixing under aeration occurs with the sludge recycled from stage I. Accordingly, the dissolved arsenic in the effluent is reduced to < 0.1 mg L(-1). The results show that this two-stage process can save more than 50% of total chemical costs, and reduce the amount of sludge by more than 50%, in comparison with the conventional Fe(III)/lime-treatment process. According to US EPA regulations, the final Fe-As sludge is classified as non-hazardous materials by the Toxicity Characteristic Leaching Procedure. But, the study shows that the instability of Fe-As sludge could be influenced by some factors, such as higher pH levels, a longer water-leaching time and larger water-leaching volume, leading to the liberation of more dissolvable As species. After being treated with Ligmet stabilizer, the Fe-As sludge showed an improved stability under varying pH conditions and large amounts of water leaching. The treated Fe-As sludge is suitable for landfill disposal.

Reflections on Centaur Upper Stage Integration by the NASA Lewis (Glenn) Research Center

NASA Technical Reports Server (NTRS)

Graham, Scott R.

2015-01-01

The NASA Glenn (then Lewis) Research Center (GRC) led several expendable launch vehicle (ELV) projects from 1963 to 1998, most notably the Centaur upper stage. These major, comprehensive projects included system management, system development, integration (both payload and stage), and launch operations. The integration role that GRC pioneered was truly unique and highly successful. Its philosophy, scope, and content were not just invaluable to the missions and vehicles it supported, but also had significant Agency-wide benefits. An overview of the NASA Lewis Research Center (now the NASA Glenn Research Center) philosophy on ELV integration is provided, focusing on Atlas/Centaur, Titan/Centaur, and Shuttle/Centaur vehicles and programs. The necessity of having a stable, highly technically competent in-house staff is discussed. Significant depth of technical penetration of contractor work is another critical component. Functioning as a cohesive team was more than a concept: GRC senior management, NASA Headquarters, contractors, payload users, and all staff worked together. The scope, content, and history of launch vehicle integration at GRC are broadly discussed. Payload integration is compared to stage development integration in terms of engineering and organization. Finally, the transition from buying launch vehicles to buying launch services is discussed, and thoughts on future possibilities of employing the successful GRC experience in integrating ELV systems like Centaur are explored.

Reflections on Centaur Upper Stage Integration by the NASA Lewis (Glenn) Research Center

NASA Technical Reports Server (NTRS)

Graham, Scott R.

2014-01-01

The NASA Glenn (then Lewis) Research Center (GRC) led several expendable launch vehicle (ELV) projects from 1963 to 1998, most notably the Centaur upper stage. These major, comprehensive projects included system management, system development, integration (both payload and stage), and launch operations. The integration role that GRC pioneered was truly unique and highly successful. Its philosophy, scope, and content were not just invaluable to the missions and vehicles it supported, but also had significant Agencywide benefits. An overview of the NASA Lewis Research Center (now the NASA Glenn Research Center) philosophy on ELV integration is provided, focusing on Atlas/Centaur, Titan/Centaur, and Shuttle/Centaur vehicles and programs. The necessity of having a stable, highly technically competent in-house staff is discussed. Significant depth of technical penetration of contractor work is another critical component. Functioning as a cohesive team was more than a concept: GRC senior management, NASA Headquarters, contractors, payload users, and all staff worked together. The scope, content, and history of launch vehicle integration at GRC are broadly discussed. Payload integration is compared to stage development integration in terms of engineering and organization. Finally, the transition from buying launch vehicles to buying launch services is discussed, and thoughts on future possibilities of employing the successful GRC experience in integrating ELV systems like Centaur are explored.

Photodynamic therapy--1994: treatment of benign and malignant upper aerodigestive tract disease

NASA Astrophysics Data System (ADS)

Schweitzer, Vanessa G.

1995-03-01

From 1983 to 1994 Phase II and III clinical studies at Henry Ford Hospital demonstrated complete or partial responses in 46 of 47 patients treated with hematoporphyrin-derivative photodynamic therapy (HPD-PDT) for a variety of benign and malignant upper aerodigestive tract disease: (1) superficial `condemned mucosa' or `field cancerization' of the oral cavity; (2) stage III/IV head and neck cancer; (3) mucocutaneous AIDS-related Kaposi's sarcoma of the upper aerodigestive tract; (4) recurrent laryngotracheal papillomatosis; (5) severe dysplasia/adenocarcinoma in situ in Barrett's esophagus; (6) partial or completely obstructing terminal esophageal cancer. HPD-PDT produced complete responses in 19 patients (follow up 6 months to 8 years) with `field cancerization' (CIS, T1) of the oral cavity and larynx (6), adenocarcinoma in situ in Barrett's esophagus (2), mucocutaneous Kaposi's sarcoma (9), obstructing esophageal carcinoma (1), and stage IV squamous cell carcinoma of the nasopharynx (1). PDT treatment protocols, results, complications, and application as adjunct or primary oncologic therapy for head and neck disease are reviewed.

Outcome for stage II and III rectal and colon cancer equally good after treatment improvement over three decades.

PubMed

Fischer, Joern; Joern, Fischer; Hellmich, Gunter; Gunter, Hellmich; Jackisch, Thomas; Thomas, Jackisch; Puffer, Erik; Erik, Puffer; Zimmer, Jörg; Jörg, Zimmer; Bleyl, Dorothea; Dorothea, Bleyl; Kittner, Thomas; Thomas, Kittner; Witzigmann, Helmut; Helmut, Witzigmann; Stelzner, Sigmar; Sigmar, Stelzner

2015-06-01

This study aimed to investigate the outcome for stage II and III rectal cancer patients compared to stage II and III colonic cancer patients with regard to 5-year cause-specific survival (CSS), overall survival, and local and combined recurrence rates over time. This prospective cohort study identified 3,355 consecutive patients with adenocarcinoma of the colon or rectum and treated in our colorectal unit between 1981 and 2011, for investigation. The study was restricted to International Union Against Cancer (UICC) stages II and III. Postoperative mortality and histological incomplete resection were excluded, which left 995 patients with colonic cancer and 726 patients with rectal cancer for further analysis. Five-year CSS rates improved for colonic cancer from 65.0% for patients treated between 1981 and 1986 to 88.1% for patients treated between 2007 and 2011. For rectal cancer patients, the respective 5-year CSS rates improved from 53.4% in the first observation period to 89.8% in the second one. The local recurrence rate for rectal cancer dropped from 34.2% in the years 1981-1986 to 2.1% in the years 2007-2011. In the last decade of observation, prognosis for rectal cancer was equal to that for colon cancer (CSS 88.6 vs. 86.7%, p = 0.409). Survival of patients with colon and rectal cancer has continued to improve over the last three decades. After major changes in treatment strategy including introduction of total mesorectal excision and neoadjuvant (radio)chemotherapy, prognosis for stage II and III rectal cancer is at least as good as for stage II and III colonic cancer.

Minimizing the Maximum Expected Sample Size in Two-Stage Phase II Clinical Trials with Continuous Outcomes

PubMed Central

Wason, James M. S.; Mander, Adrian P.

2012-01-01

Two-stage designs are commonly used for Phase II trials. Optimal two-stage designs have the lowest expected sample size for a specific treatment effect, for example, the null value, but can perform poorly if the true treatment effect differs. Here we introduce a design for continuous treatment responses that minimizes the maximum expected sample size across all possible treatment effects. The proposed design performs well for a wider range of treatment effects and so is useful for Phase II trials. We compare the design to a previously used optimal design and show it has superior expected sample size properties. PMID:22651118

Preventing Accidental Ignition of Upper-Stage Rocket Motors

NASA Technical Reports Server (NTRS)

Hickman, John; Morgan, Herbert; Cooper, Michael; Murbach, Marcus

2005-01-01

A report presents a proposal to reduce the risk of accidental ignition of certain upper-stage rocket motors or other high energy hazardous systems. At present, mechanically in-line initiators are used for initiation of many rocket motors and/or other high-energy hazardous systems. Electrical shorts and/or mechanical barriers, which are the basic safety devices in such systems, are typically removed as part of final arming or pad preparations while personnel are present. At this time, static discharge, test equipment malfunction, or incorrect arming techniques can cause premature firing. The proposal calls for a modular out-of-line ignition system incorporating detonating-cord elements, identified as the donor and the acceptor, separated by an air gap. In the safe configuration, the gap would be sealed with two shields, which would prevent an accidental firing of the donor from igniting the system. The shields would be removed to enable normal firing, in which shrapnel generated by the donor would reliably ignite the acceptor to continue the ordnance train. The acceptor would then ignite a through bulkhead initiator (or other similar device), which would ignite the motor or high-energy system. One shield would be remotely operated and would be moved to the armed position when a launch was imminent or conversely returned to the safe position if the launch were postponed. In the event of failure of the remotely operated shield, the other shield could be inserted manually to safe the system.

Postoperative radiotherapy and tumor recurrence after complete resection of stage II/III thymic tumor: a meta-analysis of cohort studies

PubMed Central

Ma, Jietao; Sun, Xin; Huang, Letian; Xiong, Zhicheng; Yuan, Meng; Zhang, Shuling; Han, Cheng-Bo

2016-01-01

Background Whether postoperative radiotherapy (PORT) is effective for reducing the recurrence risk in patients who received complete resection of the stage II or III thymic tumors has not been determined. A meta-analysis was performed by combining the results of all available controlled trials. Methods PubMed, Cochrane’s Library, and the Embase databases were searched for studies which compared the recurrence data for patients with complete resection of the stage II or III thymic tumors assigned to an observing group, or a PORT group. A random effect model was applied to combine the results. Results Nineteen studies, all designed as retrospective cohort studies were included. These studies included 663 patients of PORT group and 617 patients of observing group. The recurrence rate for the patients in PORT group and observing group were 12.4% and 11.5%, respectively. Results of our study indicated that PORT has no significant influence on recurrent risk in patients with stage II or III thymic tumor after complete resection (odds ratio 1.02, 95% confidence interval 0.55–1.90, P=0.96). When stratified by stages, our meta-analyses did not indicate any significant effects of PORT on recurrent outcomes in either the stage II or the stage III patients. Moreover, subsequent analysis limited to studies only including patients with thymoma or thymic carcinoma also did not support the benefits of PORT on recurrent outcomes. Conclusion Although derived from retrospective cohort studies, current evidence did not support any benefit of PORT on recurrent risk in patients with complete resection of the stage II or III thymic tumors. PMID:27524907

A Bayesian predictive two-stage design for phase II clinical trials.

PubMed

Sambucini, Valeria

2008-04-15

In this paper, we propose a Bayesian two-stage design for phase II clinical trials, which represents a predictive version of the single threshold design (STD) recently introduced by Tan and Machin. The STD two-stage sample sizes are determined specifying a minimum threshold for the posterior probability that the true response rate exceeds a pre-specified target value and assuming that the observed response rate is slightly higher than the target. Unlike the STD, we do not refer to a fixed experimental outcome, but take into account the uncertainty about future data. In both stages, the design aims to control the probability of getting a large posterior probability that the true response rate exceeds the target value. Such a probability is expressed in terms of prior predictive distributions of the data. The performance of the design is based on the distinction between analysis and design priors, recently introduced in the literature. The properties of the method are studied when all the design parameters vary.

Aluminum 2195 T8 Gore Development for Space Launch System Core and Upper Stage

NASA Technical Reports Server (NTRS)

Volz, Martin

2015-01-01

Gores are pie-shaped panels that are welded together to form the dome ends of rocket fuel tanks as shown in figure 1. Replacing aluminum alloy 2219 with aluminum (Al)-lithium (Li) alloy 2195 as the Space Launch System (SLS) cryogenic tank material would save enormous amounts of weight. In fact, it has been calculated that simply replacing Al 2219 gores with Al 2195 gores on the SLS core stage domes could save approximately 3,800 pound-mass. This is because the Al-Li 2195 alloy exhibits both higher mechanical properties and lower density than the SLS baseline Al 2219 alloy. Indeed, the known advantages of Al 2195 led to its use as a replacement for Al 2219 in the shuttle external tank program. The required thicknesses of Al 2195 gores for either SLS core stage tanks or upper stage tanks will depend on the specific design configurations. The required thicknesses or widths may exceed the current experience base in the manufacture of such gores by the stretch-forming process. Accordingly, the primary objective of this project was to enhance the formability of Al 2195 by optimizing the heat treatment and stretch-forming process for gore thicknesses up to 0.75 inches, which envelop the maximum expected gore thicknesses for SLS tank configurations.

Active Space Debris Removal using European Modified Launch Vehicle Upper Stages Equipped with Electrodynamic Tethers

NASA Astrophysics Data System (ADS)

Nasseri, Ali S.; Emanuelli, Matteo; Raval, Siddharth; Turconi, Andrea; Becker, Cristoph

2013-08-01

During the past few years, several research programs have assessed the current state and future evolution of the Low Earth Orbit region. These studies indicate that space debris density could reach a critical level such that there will be a continuous increase in the number of debris objects, primarily driven by debris-debris collision activity known as the Kessler effect. This cascade effect can be even more significant when intact objects as dismissed rocket bodies are involved in the collision. The majority of the studies until now have highlighted the urgency for active debris removal in the next years. An Active Debris Removal System (ADRS) is a system capable of approaching the debris object through a close-range rendezvous, establishing physical connection, stabilizing its attitude and finally de-orbiting the debris object using a type of propulsion system in a controlled manoeuvre. In its previous work, this group showed that a modified Fregat (Soyuz FG's 4th stage) or Breeze-M upper stage (Proton-M) launched from Plesetsk (Russian Federation) and equipped with an electro-dynamic tether (EDT) system can be used, after an opportune inclination's change, to de-orbit a Kosmos-3M second stage rocket body while also delivering an acceptable payload to orbit. In this paper, we continue our work on the aforementioned concept, presented at the 2012 Beijing Space Sustainability Conference, by comparing its performance to ADR missions using only chemical propulsion from the upper stage for the far approach and the de-orbiting phase. We will also update the EDT model used in our previous work and highlight some of the methods for creating physical contact with the object. Moreover, we will assess this concept also with European launch vehicles (Vega and Soyuz 2-1A) to remove space debris from space. In addition, the paper will cover some economic aspects, like the cost for the launches' operator in term of payload mass' loss at the launch. The entire debris removal

Dental Age Estimation (DAE): Data management for tooth development stages including the third molar. Appropriate censoring of Stage H, the final stage of tooth development.

PubMed

Roberts, Graham J; McDonald, Fraser; Andiappan, Manoharan; Lucas, Victoria S

2015-11-01

The final stage of dental development of third molars is usually helpful to indicate whether or not a subject is aged over 18 years. A complexity is that the final stage of development is unlimited in its upper border. Investigators usually select an inappropriate upper age limit or censor point for this tooth development stage. The literature was searched for appropriate data sets for dental age estimation and those that provided the count (n), the mean (x¯), and the standard deviation (sd) for each of the tooth development stages. The Demirjian G and Demirjian H were used for this study. Upper and lower limits of the Stage G and Stage H data were calculated limiting the data to plus or minus three standard deviations from the mean. The upper border of Stage H was limited by appropriate censoring at the maximum value for Stage G. The maximum age at attainment from published data, for Stage H, ranged from 22.60 years to 34.50 years. These data were explored to demonstrate how censoring provides an estimate for the correct maximum age for the final stage of Stage H as 21.64 years for UK Caucasians. This study shows that confining the data array of individual tooth developments stages to ± 3sd provides a reliable and logical way of censoring the data for tooth development stages with a Normal distribution of data. For Stage H this is inappropriate as it is unbounded in its upper limit. The use of a censored data array for Stage H using Percentile values is appropriate. This increases the reliability of using third molar Stage H alone to determine whether or not an individual is over 18 years old. For Stage H, individual ancestral groups should be censored using the same technique. Copyright © 2015 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Alternative Dosing of Exemestane Before Surgery in Treating Postmenopausal Patients With Stage 0-II Estrogen Positive Breast Cancer | Division of Cancer Prevention

Cancer.gov

This randomized phase IIb trial studies how well alternative dosing of exemestane before surgery works in treating in postmenopausal patients with stage 0-II estrogen positive breast cancer. Chemoprevention is the use of drugs to keep breast cancer from forming or coming back. The use of exemestane may treat early stage (stage 0-II) breast cancer. Comparing the exemestane

Opportunism or aquatic specialization? Evidence of freshwater fish exploitation at Ohalo II- A waterlogged Upper Paleolithic site

PubMed Central

Dayan, Tamar; Goren, Menachem; Nadel, Dani; Hershkovitz, Israel

2018-01-01

Analysis of ca. 17,000 fish remains recovered from the late Upper Paleolithic/early Epi-Paleolithic (LGM; 23,000 BP) waterlogged site of Ohalo II (Rift Valley, Israel) provides new insights into the role of wetland habitats and the fish inhabiting them during the evolution of economic strategies prior to the agricultural evolution. Of the current 19 native fish species in Lake Kinneret (Sea of Galilee), eight species were identified at Ohalo II, belonging to two freshwater families: Cyprinidae (carps) and Cichlidae (St. Peter fish). Employing a large set of quantitative and qualitative criteria (NISP, species richness, diversity, skeletal element representation, fragmentation, color, spatial distribution, etc.), we demonstrate that the inhabitants of Ohalo II used their knowledge of the breeding behavior of different species of fish, for year-round intensive exploitation. PMID:29912923

Opportunism or aquatic specialization? Evidence of freshwater fish exploitation at Ohalo II- A waterlogged Upper Paleolithic site.

PubMed

Zohar, Irit; Dayan, Tamar; Goren, Menachem; Nadel, Dani; Hershkovitz, Israel

2018-01-01

Analysis of ca. 17,000 fish remains recovered from the late Upper Paleolithic/early Epi-Paleolithic (LGM; 23,000 BP) waterlogged site of Ohalo II (Rift Valley, Israel) provides new insights into the role of wetland habitats and the fish inhabiting them during the evolution of economic strategies prior to the agricultural evolution. Of the current 19 native fish species in Lake Kinneret (Sea of Galilee), eight species were identified at Ohalo II, belonging to two freshwater families: Cyprinidae (carps) and Cichlidae (St. Peter fish). Employing a large set of quantitative and qualitative criteria (NISP, species richness, diversity, skeletal element representation, fragmentation, color, spatial distribution, etc.), we demonstrate that the inhabitants of Ohalo II used their knowledge of the breeding behavior of different species of fish, for year-round intensive exploitation.

Two-stage phase II oncology designs using short-term endpoints for early stopping.

PubMed

Kunz, Cornelia U; Wason, James Ms; Kieser, Meinhard

2017-08-01

Phase II oncology trials are conducted to evaluate whether the tumour activity of a new treatment is promising enough to warrant further investigation. The most commonly used approach in this context is a two-stage single-arm design with binary endpoint. As for all designs with interim analysis, its efficiency strongly depends on the relation between recruitment rate and follow-up time required to measure the patients' outcomes. Usually, recruitment is postponed after the sample size of the first stage is achieved up until the outcomes of all patients are available. This may lead to a considerable increase of the trial length and with it to a delay in the drug development process. We propose a design where an intermediate endpoint is used in the interim analysis to decide whether or not the study is continued with a second stage. Optimal and minimax versions of this design are derived. The characteristics of the proposed design in terms of type I error rate, power, maximum and expected sample size as well as trial duration are investigated. Guidance is given on how to select the most appropriate design. Application is illustrated by a phase II oncology trial in patients with advanced angiosarcoma, which motivated this research.

Dose-Escalated Robotic SBRT for Stage I–II Prostate Cancer

PubMed Central

Meier, Robert

2015-01-01

Stereotactic body radiotherapy (SBRT) is the precise external delivery of very high-dose radiotherapy to targets in the body, with treatment completed in one to five fractions. SBRT should be an ideal approach for organ-confined prostate cancer because (I) dose-escalation should yield improved rates of cancer control; (II) the unique radiobiology of prostate cancer favors hypofractionation; and (III) the conformal nature of SBRT minimizes high-dose radiation delivery to immediately adjacent organs, potentially reducing complications. This approach is also more convenient for patients, and is cheaper than intensity-modulated radiotherapy (IMRT). Several external beam platforms are capable of delivering SBRT for early-stage prostate cancer, although most of the mature reported series have employed a robotic non-coplanar platform (i.e., CyberKnife). Several large studies report 5-year biochemical relapse rates which compare favorably to IMRT. Rates of late GU toxicity are similar to those seen with IMRT, and rates of late rectal toxicity may be less than with IMRT and low-dose rate brachytherapy. Patient-reported quality of life (QOL) outcomes appear similar to IMRT in the urinary domain. Bowel QOL may be less adversely affected by SBRT than with other radiation modalities. After 5 years of follow-up, SBRT delivered on a robotic platform is yielding outcomes at least as favorable as IMRT, and may be considered appropriate therapy for stage I–II prostate cancer. PMID:25905037

Environmental protection requirements for scout/shuttle auxiliary stages

NASA Technical Reports Server (NTRS)

Qualls, G. L.; Kress, S. S.; Storey, W. W.; Ransdell, P. N.

1980-01-01

The requirements for enabling the Scout upper stages to endure the expected temperature, mechanical shock, acoustical and mechanical vibration environments during a specified shuttle mission were determined. The study consisted of: determining a shuttle mission trajectory for a 545 kilogram (1200 pound) Scout payload; compilation of shuttle environmental conditions; determining of Scout upper stages environments in shuttle missions; compilation of Scout upper stages environmental qualification criteria and comparison to shuttle mission expected environments; and recommendations for enabling Scout upper stages to endure the exptected shuttle mission environments.

Family Caregiver Palliative Care Intervention in Supporting Caregivers of Patients With Stage II-IV Gastrointestinal, Gynecologic, Urologic and Lung Cancers

ClinicalTrials.gov

2018-02-12

Healthy Subject; Localized Transitional Cell Cancer of the Renal Pelvis and Ureter; Metastatic Transitional Cell Cancer of the Renal Pelvis and Ureter; Psychosocial Effects of Cancer and Its Treatment; Recurrent Bladder Cancer; Recurrent Cervical Cancer; Recurrent Colon Cancer; Recurrent Gastric Cancer; Recurrent Ovarian Epithelial Cancer; Recurrent Ovarian Germ Cell Tumor; Recurrent Pancreatic Cancer; Recurrent Rectal Cancer; Recurrent Renal Cell Cancer; Recurrent Transitional Cell Cancer of the Renal Pelvis and Ureter; Recurrent Urethral Cancer; Recurrent Uterine Sarcoma; Regional Transitional Cell Cancer of the Renal Pelvis and Ureter; Stage II Bladder Cancer; Stage II Renal Cell Cancer; Stage II Urethral Cancer; Stage IIA Cervical Cancer; Stage IIA Colon Cancer; Stage IIA Gastric Cancer; Stage IIA Ovarian Epithelial Cancer; Stage IIA Ovarian Germ Cell Tumor; Stage IIA Pancreatic Cancer; Stage IIA Rectal Cancer; Stage IIA Uterine Sarcoma; Stage IIB Cervical Cancer; Stage IIB Colon Cancer; Stage IIB Gastric Cancer; Stage IIB Ovarian Epithelial Cancer; Stage IIB Ovarian Germ Cell Tumor; Stage IIB Pancreatic Cancer; Stage IIB Rectal Cancer; Stage IIB Uterine Sarcoma; Stage IIC Colon Cancer; Stage IIC Ovarian Epithelial Cancer; Stage IIC Ovarian Germ Cell Tumor; Stage IIC Rectal Cancer; Stage III Bladder Cancer; Stage III Pancreatic Cancer; Stage III Renal Cell Cancer; Stage III Urethral Cancer; Stage IIIA Cervical Cancer; Stage IIIA Colon Cancer; Stage IIIA Gastric Cancer; Stage IIIA Ovarian Epithelial Cancer; Stage IIIA Ovarian Germ Cell Tumor; Stage IIIA Rectal Cancer; Stage IIIA Uterine Sarcoma; Stage IIIB Cervical Cancer; Stage IIIB Colon Cancer; Stage IIIB Gastric Cancer; Stage IIIB Ovarian Epithelial Cancer; Stage IIIB Ovarian Germ Cell Tumor; Stage IIIB Rectal Cancer; Stage IIIB Uterine Sarcoma; Stage IIIC Colon Cancer; Stage IIIC Gastric Cancer; Stage IIIC Ovarian Epithelial Cancer; Stage IIIC Ovarian Germ Cell Tumor; Stage IIIC Rectal Cancer; Stage IIIC

Overexpression of the S100A2 protein as a prognostic marker for patients with stage II and III colorectal cancer

PubMed Central

MASUDA, TAIKI; ISHIKAWA, TOSHIAKI; MOGUSHI, KAORU; OKAZAKI, SATOSHI; ISHIGURO, MEGUMI; IIDA, SATORU; MIZUSHIMA, HIROSHI; TANAKA, HIROSHI; UETAKE, HIROYUKI; SUGIHARA, KENICHI

2016-01-01

We aimed to identify a novel prognostic biomarker related to recurrence in stage II and III colorectal cancer (CRC) patients. Stage II and III CRC tissue mRNA expression was profiled using an Affymetrix Gene Chip, and copy number profiles of 125 patients were generated using an Affymetrix 250K Sty array. Genes showing both upregulated expression and copy number gains in cases involving recurrence were extracted as candidate biomarkers. The protein expression of the candidate gene was assessed using immunohistochemical staining of tissue from 161 patients. The relationship between protein expression and clinicopathological features was also examined. We identified 9 candidate genes related to recurrence of stage II and III CRC, whose mRNA expression was significantly higher in CRC than in normal tissue. Of these proteins, the S100 calcium-binding protein A2 (S100A2) has been observed in several human cancers. S100A2 protein overexpression in CRC cells was associated with significantly worse overall survival and relapse-free survival, indicating that S100A2 is an independent risk factor for stage II and III CRC recurrence. S100A2 overexpression in cancer cells could be a biomarker of poor prognosis in stage II and III CRC recurrence and a target for treatment of this disease. PMID:26783118

40 CFR 51.126 - Determination of widespread use of ORVR and waiver of CAA section 182(b)(3) Stage II gasoline...

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 2 2012-07-01 2012-07-01 false Determination of widespread use of ORVR and waiver of CAA section 182(b)(3) Stage II gasoline vapor recovery requirements. 51.126 Section 51... Determination of widespread use of ORVR and waiver of CAA section 182(b)(3) Stage II gasoline vapor recovery...

Correlation between hindfoot joint three-dimensional kinematics and the changes of the medial arch angle in stage II posterior tibial tendon dysfunction flatfoot.

PubMed

Zhang, Yi-Jun; Xu, Jian; Wang, Yue; Lin, Xiang-Jin; Ma, Xin

2015-02-01

The aim of this study was to explore the correlation between the kinematics of the hindfoot joint and the medial arch angle change in stage II posterior tibial tendon dysfunction flatfoot three-dimensionally under loading. Computed tomography (CT) scans of 12 healthy feet and 12 feet with stage II posterior tibial tendon dysfunction flatfoot were taken both in non- and full-body-weight-bearing condition. The CT images of the hindfoot bones were reconstructed into three-dimensional models with Mimics and Geomagic reverse engineering software. The three-dimensional changes of the hindfoot joint were calculated to determine their correlation to the medial longitudinal arch angle. The medial arch angle change was larger in stage II posterior tibial tendon dysfunction flatfoot compared to that in healthy foot under loading. The rotation and translation of the talocalcaneal joint, the talonavicular joint and the calcanocuboid joint had little influence on the change of the medial arch angle in healthy foot. However, the eversion of the talocalcaneal joint, the proximal translation of the calcaneus relative to the talus and the dorsiflexion of talonavicular joint could increase the medial arch angle in stage II posterior tibial tendon dysfunction flatfoot under loading. Joint instability occurred in patients with stage II posterior tibial tendon dysfunction flatfoot under loading. Limitation of over movement of the talocalcaneal joint and the talonavicular joint may help correct the medial longitudinal arch in stage II posterior tibial tendon dysfunction flatfoot. Copyright © 2014 Elsevier Ltd. All rights reserved.

Combination Chemotherapy With or Without Bortezomib in Treating Younger Patients With Newly Diagnosed T-Cell Acute Lymphoblastic Leukemia or Stage II-IV T-Cell Lymphoblastic Lymphoma

ClinicalTrials.gov

2018-06-27

Adult T Acute Lymphoblastic Leukemia; Ann Arbor Stage II Adult Lymphoblastic Lymphoma; Ann Arbor Stage II Childhood Lymphoblastic Lymphoma; Ann Arbor Stage III Adult Lymphoblastic Lymphoma; Ann Arbor Stage III Childhood Lymphoblastic Lymphoma; Ann Arbor Stage IV Adult Lymphoblastic Lymphoma; Ann Arbor Stage IV Childhood Lymphoblastic Lymphoma; Childhood T Acute Lymphoblastic Leukemia; Untreated Adult Acute Lymphoblastic Leukemia; Untreated Childhood Acute Lymphoblastic Leukemia

Survival Impact of Adjuvant Radiation Therapy in Masaoka Stage II to IV Thymomas: A Systematic Review and Meta-analysis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lim, Yu Jin; Kim, Eunji; Kim, Hak Jae, E-mail: khjae@snu.ac.kr

Purpose: To evaluate the survival impact of postoperative radiation therapy (PORT) in stage II to IV thymomas, using systematic review and meta-analysis. Methods and Materials: A database search was conducted with EMBASE, PubMed, Web of Science, Cochrane Library, and Ovid from inception to August 2015. Thymic carcinomas were excluded, and studies comparing overall survival (OS) with and without PORT in thymomas were included. The hazard ratios (HRs) of OS were extracted, and a random-effects model was used in the pooled analysis. Results: Seven retrospective series with a total of 1724 patients were included and analyzed. Almost all of the patients underwentmore » macroscopically complete resection, and thymoma histology was confirmed by the World Health Organization criteria. In the overall analysis of stage II to IV thymomas, OS was not altered with the receipt of PORT (HR 0.79, 95% confidence interval [CI] 0.58-1.08). Although PORT was not associated with survival difference in Masaoka stage II disease (HR 1.45, 95% CI 0.83-2.55), improved OS was observed with the addition of PORT in the discrete pooled analysis of stage III to IV (HR 0.63, 95% CI 0.40-0.99). Significant heterogeneity and publication bias were not found in the analyses. Conclusions: From the present meta-analysis of sole primary thymomas, we suggest the potential OS benefit of PORT in locally advanced tumors with macroscopically complete resection, but not in stage II disease. Further investigations with sufficient survival data are needed to establish detailed treatment indications.« less

Brentuximab Vedotin or Crizotinib and Combination Chemotherapy in Treating Patients With Newly Diagnosed Stage II-IV Anaplastic Large Cell Lymphoma

ClinicalTrials.gov

2018-06-25

Anaplastic Large Cell Lymphoma, ALK-Positive; Ann Arbor Stage II Noncutaneous Childhood Anaplastic Large Cell Lymphoma; Ann Arbor Stage III Noncutaneous Childhood Anaplastic Large Cell Lymphoma; Ann Arbor Stage IV Noncutaneous Childhood Anaplastic Large Cell Lymphoma; CD30-Positive Neoplastic Cells Present

Low Cost Upper Stage-Class Propulsion (LCUSP)

NASA Technical Reports Server (NTRS)

Vickers, John

2015-01-01

NASA is making space exploration more affordable and viable by developing and utilizing innovative manufacturing technologies. Technology development efforts at NASA in propulsion are committed to continuous innovation of design and manufacturing technologies for rocket engines in order to reduce the cost of NASA's journey to Mars. The Low Cost Upper Stage-Class Propulsion (LCUSP) effort will develop and utilize emerging Additive Manufacturing (AM) to significantly reduce the development time and cost for complex rocket propulsion hardware. Benefit of Additive Manufacturing (3-D Printing) Current rocket propulsion manufacturing techniques are costly and have lengthy development times. In order to fabricate rocket engines, numerous complex parts made of different materials are assembled in a way that allow the propellant to collect heat at the right places to drive the turbopump and simultaneously keep the thrust chamber from melting. The heat conditioned fuel and oxidizer come together and burn inside the combustion chamber to provide thrust. The efforts to make multiple parts precisely fit together and not leak after experiencing cryogenic temperatures on one-side and combustion temperatures on the other is quite challenging. Additive manufacturing has the potential to significantly reduce the time and cost of making rocket parts like the copper liner and Nickel-alloy jackets found in rocket combustion chambers where super-cold cryogenic propellants are heated and mixed to the extreme temperatures needed to propel rockets in space. The Selective Laser Melting (SLM) machine fuses 8,255 layers of copper powder to make a section of the chamber in 10 days. Machining an equivalent part and assembling it with welding and brazing techniques could take months to accomplish with potential failures or leaks that could require fixes. The design process is also enhanced since it does not require the 3D model to be converted to 2-D drawings. The design and fabrication process

Two-Stage Technique Used to Manage Severe Upper Airway Obstruction and Avoid Surgical Tracheostomy: A Case Report.

PubMed

Onwochei, Desire N; El-Boghdadly, Kariem; Ahmad, Imran

2018-03-01

Severe upper airway obstruction is commonly managed with surgical tracheostomy under local anesthesia. We present a 49-year-old woman with postradiotherapy laryngeal fixation and transglottic stenosis for dilation of a pharyngeal stricture who refused elective tracheostomy. A 2-stage technique was used, which involved an awake fiberoptic intubation, followed by the transtracheal insertion of a Cricath needle and ventilation using an ejector-based Ventrain device. We discuss management aspects of this clinical scenario and the principles by which the Ventrain works.

Association between Recurrent Metastasis from Stage II and III Primary Colorectal Tumors and Moderate Microsatellite Instability

PubMed Central

Garcia, Melissa; Choi, Chan; Kim, Hyeong-Rok; Daoud, Yahya; Toiyama, Yuji; Takahashi, Masanobu; Goel, Ajay; Boland, C Richard; Koi, Minoru

2012-01-01

Colorectal cancer (CRC) cells frequently have low levels of microsatellite instability (MSI-L) and elevated microsatellite alterations at tetranucleotide repeats (EMAST), but little is known about the clinicopathological significance of these features. We observed that patients with stage II or III CRC with MSI-L and/or EMAST had a shorter times of recurrence-free survival than patients with high levels of MSI (MSI-H) (P=.0084) or with highly stable microsatellites (H-MSS) (P=.0415), based on Kaplan-Meier analysis. MSI-L and/or EMAST were independent predictors of recurrent distant metastasis from primary stage II or III colorectal tumors (Cox proportional hazard analysis hazard ratio, 1.83; 95% confidence interval, 1.06–3.15; P=.0301). PMID:22465427

FISH COMMUNITIES IN LAKE IN SUBREGION 2B (UPPER PENINSULA OF MICHIGAN) IN RELATION TO LAKE ACIDITY: VOLUME II. APPENDICES

EPA Science Inventory

Surveys of fish community status were conducted in summer 1987 in 49 lakes in Subregion 20, the Upper Peninsula of Michigan, as part of Phase II of the Eastern Lake Survey. Lake selection involved a variable probability sampling design. Fish communities were surveyed using gill n...

Bevacizumab, Cisplatin, Radiation Therapy, and Fluorouracil in Treating Patients With Stage IIB, Stage III, Stage IVA, or Stage IVB Nasopharyngeal Cancer

ClinicalTrials.gov

2018-01-04

Stage II Nasopharyngeal Keratinizing Squamous Cell Carcinoma AJCC v7; Stage III Nasopharyngeal Keratinizing Squamous Cell Carcinoma AJCC v7; Stage III Nasopharyngeal Undifferentiated Carcinoma AJCC v7; Stage IV Nasopharyngeal Keratinizing Squamous Cell Carcinoma AJCC v7; Stage IV Nasopharyngeal Undifferentiated Carcinoma AJCC v7

MK2206 in Treating Patients With Stage I, Stage II, or Stage III Breast Cancer

ClinicalTrials.gov

2017-08-01

Estrogen Receptor Negative; Estrogen Receptor Positive; HER2/Neu Negative; HER2/Neu Positive; Progesterone Receptor Negative; Progesterone Receptor Positive; Stage IA Breast Cancer; Stage IB Breast Cancer; Stage IIA Breast Cancer; Stage IIB Breast Cancer; Stage IIIA Breast Cancer; Stage IIIB Breast Cancer; Stage IIIC Breast Cancer; Triple-Negative Breast Carcinoma

Active Debris Removal Using Modified Launch Vehicle Upper Stages

NASA Astrophysics Data System (ADS)

Nasseri, S. Ali; Emanuelli, Matteo; Raval, Siddharth; Turconi, Andrea

2013-09-01

During the past few years, several research programs have assessed the current state and future evolution of space debris in the Low Earth Orbit region. These studies indicate that space debris density could reach a critical level such that there will be a continuous increase in the number of debris objects, primarily driven by debris-debris collision activity known as the Kessler effect. These studies also highlight the urgency for active debris removal.An Active Debris Removal System (ADRS) is capable of approaching the debris object through a close-range rendezvous, stabilizing its attitude, establishing physical contact, and finally de-orbiting the debris object. The de-orbiting phase could be powered by propulsion systems such as chemical rockets or electrodynamic tether (EDT) systems.The aim of this project is to model and evaluate a debris removal mission in which an adapted rocket upper stage, equipped with an electrodynamic tether (EDT) system, is employed for de-orbiting a debris object. This ADRS package is installed initially as part of a launch vehicle on a normal satellite deployment mission, and a far-approach manoeuvre will be required to align the ADRS' orbit with that of the target debris. We begin by selecting a suitable target debris and launch vehicle, and then proceed with modelling the entire debris removal mission from launch to de-orbiting of the target debris object using Analytical Graphic Inc.'s Systems Tool Kit (STK).

Stratospheric Aerosol and Gas Experiment (SAGE) II and III Aerosol Extinction Measurements in the Arctic Middle and Upper Troposphere

NASA Technical Reports Server (NTRS)

Treffeisen, R. E.; Thomason, L. W.; Strom, J.; Herber, A. B.; Burton, S. P.; Yamanouchi, T.

2006-01-01

In recent years, substantial effort has been expended toward understanding the impact of tropospheric aerosols on Arctic climate and chemistry. A significant part of this effort has been the collection and documentation of extensive aerosol physical and optical property data sets. However, the data sets present significant interpretive challenges because of the diverse nature of these measurements. Among the longest continuous records is that by the spaceborne Stratospheric Aerosol and Gas Experiment (SAGE) II. Although SAGE tropospheric measurements are restricted to the middle and upper troposphere, they may be able to provide significant insight into the nature and variability of tropospheric aerosol, particularly when combined with ground and airborne observations. This paper demonstrates the capacity of aerosol products from SAGE II and its follow-on experiment SAGE III to describe the temporal and vertical variations of Arctic aerosol characteristics. We find that the measurements from both instruments are consistent enough to be combined. Using this combined data set, we detect a clear annual cycle in the aerosol extinction for the middle and upper Arctic troposphere.

The possible influence of upstream upper-level baroclinic processes on the development of the QE II storm

NASA Technical Reports Server (NTRS)

Uccellini, L. W.

1986-01-01

An analysis of the QE II storm of September 9-11, 1978 presents evidence for the existence of upper-level baroclinic processes upstream of the rapidly developing cyclone. The analysis shows that a deepening shortwave trough was located 400 to 500 km upstream of the site of the storm 12 h prior to rapid cyclogenesis. The trough was associated with: (1) a polar jet marked by 65 m/s winds in its core and significant vertical and horizontal wind shear, (2) positive vorticity advection and divergence at the 300 mb level, and (3) an intense frontal zone that extended from 300 mb down to the surface. It also appears that a tropopause fold likely extruded stratospheric air down to the 700-800 mb level, 400-500 km upstream of the surface low and 12 h prior to the explosive development phase of the cyclone. These findings raise questions about Gyakum's (1983) assertion that the QE II storm developed in an area in which the baroclinic support was confined to the lower troposphere and the related assertion by Anthes et al. (1983) that upper-level forcing upstream of the area of rapid cyclogenesis was weak and apparently not important in this case.

Solar thermal upper stage technology demonstrator liquid hydrogen storage and feed system test program

NASA Astrophysics Data System (ADS)

Cady, E. C.

1997-01-01

The Solar Thermal Upper Stage Technology Demonstrator (STUSTD) Liquid Hydrogen Storage and Feed System (LHSFS) Test Program is described. The test program consists of two principal phases. First, an engineering characterization phase includes tests performed to demonstrate and understand the expected tank performance. This includes fill and drain; baseline heat leak; active Thermodynamic Vent System (TVS); and flow tests. After the LHSFS performance is understood and performance characteristics are determined, a 30 day mission simulation test will be conducted. This test will simulate a 30 day transfer mission from low earth orbit (LEO) to geosynchronous equatorial orbit (GEO). Mission performance predictions, based on the results of the engineering characterization tests, will be used to correlate the results of the 30 day mission simulation.

IUS/TUG orbital operations and mission support study. Volume 2: Interim upper stage operations

NASA Technical Reports Server (NTRS)

1975-01-01

Background data and study results are presented for the interim upper stage (IUS) operations phase of the IUS/tug orbital operations study. The study was conducted to develop IUS operational concepts and an IUS baseline operations plan, and to provide cost estimates for IUS operations. The approach used was to compile and evaluate baseline concepts, definitions, and system, and to use that data as a basis for the IUS operations phase definition, analysis, and costing analysis. Both expendable and reusable IUS configurations were analyzed and two autonomy levels were specified for each configuration. Topics discussed include on-orbit operations and interfaces with the orbiter, the tracking and data relay satellites and ground station support capability analysis, and flight control center sizing to support the IUS operations.

Aquaporin 1 expression is associated with response to adjuvant chemotherapy in stage II and III colorectal cancer.

PubMed

Imaizumi, Hideko; Ishibashi, Keiichiro; Takenoshita, Seiichi; Ishida, Hideyuki

2018-05-01

Aquaporin 1 (AQP1), which functions as a water transporter, is associated with cancer cell proliferation, invasion, metastasis and angiogenesis in numerous types of solid cancer, including colorectal cancer (CRC). The focus of the present study was to address the potential clinical use of AQP1 expression in CRC as a prognostic and predictive biomarker for disease recurrence and therapeutic outcomes. The current study investigated the expression of AQP1 in surgically resected specimens from 268 patients with stage 0-IV CRC. AQP1 expression was positive in 112 (41.8%) patients, and was significantly associated with left-sided tumors (P<0.01) and with aggressive tumor phenotypes, including depth of invasion (P=0.03), lymph node metastasis (P=0.03), lymphatic invasion (P<0.01) and venous invasion (P<0.01). However, AQP1 expression had no significant prognostic effect on disease-free survival (DFS) in patients with stage II and III CRC following curative surgery. In 84 stage II and III patients who were administered 5-fluorouracil-based adjuvant chemotherapy, positive AQP1 expression was associated with an increased DFS rate compared with that of AQP1-negative patients (P=0.05). Additionally, these results identified that receiving adjuvant chemotherapy was not beneficial to patients with AQP1-negative tumors. This suggests that the expression of AQP1 may be a candidate biomarker predictive of response to 5-fluorouracil-based adjuvant chemotherapy following surgery in patients with stage II and III CRC.

Flight results of attitude matching between Space Shuttle and Inertial Upper Stage (IUS) navigation systems

NASA Astrophysics Data System (ADS)

Treder, Alfred J.; Meldahl, Keith L.

The recorded histories of Shuttle/Orbiter attitude and Inertial Upper Stage (IUS) attitude have been analyzed for all joint flights of the IUS in the Orbiter. This database was studied to determine the behavior of relative alignment between the IUS and Shuttle navigation systems. It is found that the overall accuracy of physical alignment has a Shuttle Orbiter bias component less than 5 arcmin/axis and a short-term stability upper bound of 0.5 arcmin/axis, both at 1 sigma. Summaries of the experienced physical and inertial alginment offsets are shown in this paper, together with alignment variation data, illustrated with some flight histories. Also included is a table of candidate values for some error source groups in an Orbiter/IUS attitude errror model. Experience indicates that the Shuttle is much more accurate and stable as an orbiting launch platform than has so far been advertised. This information will be valuable for future Shuttle payloads, especially those (such as the Aeroassisted Flight Experiment) which carry their own inertial navigation systems, and which could update or initialize their attitude determination systems using the Shuttle as the reference.

Management of stage II colon cancer - the use of molecular biomarkers for adjuvant therapy decision

PubMed Central

2013-01-01

Background There is uncertainty on the benefit of adjuvant chemotherapy in patients with stage II colorectal cancers. The aim of this study is to investigate the combined role of clinical, pathological and molecular parameters to identify those stage II patients who better benefit from adjuvant therapy. Methods We examined 120 stage II colon cancer patients. Of these, 60 patients received adjuvant 5-FU chemotherapy after surgery and the other 60 did not receive therapy. Immunohistochemical (IHC) analyses were performed to evaluate the expressions of Thymidylate synthetase (TYMS), TP53 (p53), β-catenin (CTNNB1) and CD8. For TYMS, its mRNA expression levels were also investigated by real time qRT-PCR. The entire case study was characterized by the presence of a defect in the MMR (mismatch repair) system, the presence of the CpG island methylator phenotype (CIMP or CIMP-High) and for the V600E mutation in the BRAF gene. At the histo-pathological level, the depth of tumour invasion, lymphovascular invasion, invasion of large veins, host lymphocytic response and tumour border configuration were recorded. Results The presence of the V600E mutation in the BRAF gene was a poor prognostic factor for disease free and overall survival (DFS; hazard ratio [HR], 2.57; 95% CI: 1.03 -6.37; p = 0.04 and OS; HR, 3.68; 95% CI: 1.43-9.47; p < 0.01 respectively), independently of 5-FU treatment. Adjuvant therapy significantly improved survival in patients with high TYMS levels (p = 0.04), while patients with low TYMS had a better outcome if treated by surgery alone (DFS; HR, 6.07; 95% CI, 0.82 to 44.89; p = 0.04). In patients with a defect in the MMR system (dMMR), 5-FU therapy was associated to reduced survival (DFS; HR, 37.98; 95% CI, 1.04 to 1381.31; p = 0.04), while it was beneficial for CIMP-High associated tumours (DFS; HR, 0.17; 95% CI, 0.02 to 1.13; p = 0.05). Conclusions Patients’ characterization according to MMR status, CIMP phenotype and TYMS m

78 FR 58884 - Approval and Promulgation of Implementation Plans; Kentucky; Stage II Requirements for Enterprise...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-25

...] Approval and Promulgation of Implementation Plans; Kentucky; Stage II Requirements for Enterprise Holdings... Kentucky Division for Air Quality (KDAQ) on April 25, 2013, for the purpose of exempting an Enterprise... subject Enterprise Holdings, Inc., facility is currently being constructed at the Cincinnati/Northern...

Axillary radiotherapy in conservative surgery for early-stage breast cancer (stage I and II).

PubMed

García Novoa, Alejandra; Acea Nebril, Benigno; Díaz, Inma; Builes Ramírez, Sergio; Varela, Cristina; Cereijo, Carmen; Mosquera Oses, Joaquín; López Calviño, Beatriz; Seoane Pillado, María Teresa

2016-01-01

Several clinical studies analyze axillary treatment in women with early-stage breast cancer because of changes in the indication for axillary lymph node dissection. The aim of the study is to analyze the impact of axillary radiotherapy in disease-free and overall survival in women with early breast cancer treated with lumpectomy. Retrospective study in women with initial stages of breast carcinoma treated by lumpectomy. A comparative analysis of high-risk women with axillary lymph node involvement who received axillary radiotherapy with the group of women with low risk without radiotherapy was performed. Logistic regression was used to determine factors influencing survival and lymphedema onset. A total of 541 women were included in the study: 384 patients (71%) without axillary lymph node involvement and 157 women (29%) with 1-3 axillary lymph node involvement. Patients with axillary radiotherapy had a higher number of metastatic lymph node compared to non-irradiated (1.6±0.7 vs. 1.4±0.6, P=.02). The group of women with axillary lymph node involvement and radiotherapy showed an overall and disease-free survival at 10 years similar to that obtained in patients without irradiation (89.7% and 77.2%, respectively). 3 lymph nodes involved multiplied by more than 7 times the risk of death (HR=7.20; 95% CI: 1.36 to 38.12). The multivariate analysis showed axillary lymph node dissection as the only variable associated with the development of lymphedema. The incidence of axillary relapse on stage I and II breast cancer is rare. In these patients axillary radiotherapy does not improve overall survival, but contributes to regional control in those patients with risk factors. Copyright © 2016 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

The Status of National Values in the Books of Social Studies for the Grades of the Upper Primary Stage in Jordan

ERIC Educational Resources Information Center

Subheyyin, Eid H.; Mawajdeh, Baker S.; Talhouni, Mansour H.; Rfou', Mohammad O.

2017-01-01

This study aimed at determining the most important national values that should be included in the textbooks of social studies for the upper-primary stage grades in Jordan; and then identifying the degree of their inclusion in those books. The study used a descriptive-analytical approach. A study tool which includes twelve national values was…

Acid phosphatase patterns in microfilariae of Onchocerca volvulus s.l. from the Upper Orinoco Basin, Venezuela.

PubMed

Yarzàbal, L; Petralanda, I; Arango, M; Lobo, L; Botto, C

1983-06-01

The patterns of acid phosphatase in strains of Onchocerca volvulus s.l. which parasitize an Amerindian population (Yanomami) in Venezuela's Upper Orinoco Basin were examined by using the naphthol AS-TR phosphate method. The study sample consisted of 40 Yanomami inhabiting a savannah area at 950 m above sea level and 21 Yanomami residents of a tropical rainforest area at an altitude of 250 m. Stained intrauterine microfilariae, still within the egg case, exhibited a diffuse distribution of the enzyme in the early stages of embryonic development and a negative reaction at a more developed stage. Four of the five enzyme staining patterns described by Omar (1978) were found in the 3157 microfilariae examined from skin snips. Their distribution was: Type I--17.2%, Type III--0.5%, Type IV--75.6% and Type V--6.6%. No examples of Type II were observed. The results indicate that acid phosphatase patterns of the Upper Orinoco Onchocerca strain most resemble those of strains from Guatemala and Yemen, and are different from the African strains found in Upper Volta and Liberia. The relative frequency of acid phosphatase patterns was modified by cryopreservation of microfilariae.

Additive Manufacturing of Low Cost Upper Stage Propulsion Components

NASA Technical Reports Server (NTRS)

Protz, Christopher; Bowman, Randy; Cooper, Ken; Fikes, John; Taminger, Karen; Wright, Belinda

2014-01-01

NASA is currently developing Additive Manufacturing (AM) technologies and design tools aimed at reducing the costs and manufacturing time of regeneratively cooled rocket engine components. These Low Cost Upper Stage Propulsion (LCUSP) tasks are funded through NASA's Game Changing Development Program in the Space Technology Mission Directorate. The LCUSP project will develop a copper alloy additive manufacturing design process and develop and optimize the Electron Beam Freeform Fabrication (EBF3) manufacturing process to direct deposit a nickel alloy structural jacket and manifolds onto an SLM manufactured GRCop chamber and Ni-alloy nozzle. In order to develop these processes, the project will characterize both the microstructural and mechanical properties of the SLMproduced GRCop-84, and will explore and document novel design techniques specific to AM combustion devices components. These manufacturing technologies will be used to build a 25K-class regenerative chamber and nozzle (to be used with tested DMLS injectors) that will be tested individually and as a system in hot fire tests to demonstrate the applicability of the technologies. These tasks are expected to bring costs and manufacturing time down as spacecraft propulsion systems typically comprise more than 70% of the total vehicle cost and account for a significant portion of the development schedule. Additionally, high pressure/high temperature combustion chambers and nozzles must be regeneratively cooled to survive their operating environment, causing their design to be time consuming and costly to build. LCUSP presents an opportunity to develop and demonstrate a process that can infuse these technologies into industry, build competition, and drive down costs of future engines.

Application of GPS to Enable Launch Vehicle Upper Stage Heliocentric Disposal

NASA Technical Reports Server (NTRS)

Anzalone, Evan J.; Oliver, T. Emerson

2017-01-01

To properly dispose of the upper stage of the Space Launch System, the vehicle must perform a burn in Earth orbit to perform a close flyby of the Lunar surface to gain adequate energy to enter into heliocentric space. This architecture was selected to meet NASA requirements to limit orbital debris in the Earth-Moon system. The choice of a flyby for heliocentric disposal was driven by mission and vehicle constraints. This paper describes the SLS mission for Exploration Mission -1, a high level overview of the Block 1 vehicle, and the various disposal options considered. The research focuses on this analysis in terms of the mission design and navigation problem, focusing on the vehicle-level requirements that enable a successful mission. An inertial-only system is shown to be insufficient for heliocentric flyby due to large inertial integration errors from launch through disposal maneuver while on a trans-lunar trajectory. The various options for aiding the navigation system are presented and details are provided on the use of GPS to bound the state errors in orbit to improve the capability for stage disposal. The state estimation algorithm used is described as well as its capability in determination of the vehicle state at the start of the planned maneuver. This data, both dispersions on state and on errors, is then used to develop orbital targets to use for meeting the required Lunar flyby for entering onto a heliocentric trajectory. The effect of guidance and navigation errors on this capability is described as well as the identified constraints for achieving the disposal requirements. Additionally, discussion is provided on continued analysis and identification of system considerations that can drive the ability to integrate onto a vehicle intended for deep space.

Effect of {sup 18}F-FDG PET/CT Imaging in Patients With Clinical Stage II and III Breast Cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Groheux, David; Moretti, Jean-Luc; EAD Imagerie Moleculaire Diagnostique et Ciblage Therapeutique, IUH, University of Paris VII, Paris

2008-07-01

Purpose: To investigate the potential effect of using {sup 18}F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) in the initial assessment of patients with clinical Stage II or III breast cancer. Methods and Materials: During 14 consecutive months, 39 patients (40 tumors) who presented with Stage II or III breast cancer on the basis of a routine extension assessment were prospectively included in this study. PET/CT was performed in addition to the initial assessment. Results: In 3 cases, PET/CT showed extra-axillary lymph node involvement that had not been demonstrated with conventional techniques. Two of these patients had hypermetabolic lymph nodes in themore » subpectoral and infraclavicular regions, and the third had a hypermetabolic internal mammary node. PET/CT showed distant uptake in 4 women. Of these 4 women, 1 had pleural involvement and 3 had bone metastasis. Overall, of the 39 women, the PET/CT results modified the initial stage in 7 (18%). The modified staging altered the treatment plan for 5 patients (13%). It led to radiotherapy in 4 patients (bone metastasis, pleural lesion, subpectoral lymph nodes, and internal mammary nodes) and excision of, and radiotherapy to, the infraclavicular lymph nodes in 1 patient. Conclusions: PET/CT can provide information on extra-axillary lymph node involvement and can uncover occult distant metastases in a significant percentage of patients. Therefore, initial PET/CT could enable better treatment planning for patients with Stage II and III breast cancer.« less

Evidence for slowdown in stratospheric ozone loss: First stage of ozone recovery

NASA Technical Reports Server (NTRS)

Newchurch, M. J.; Yang, Eun-Su; Cunnold, D. M.; Reinsel, C.; Zawodny, J. M.; Russell, James M., III

2003-01-01

Global ozone trends derived from the Stratospheric Aerosol and Gas Experiment I and II (SAGE I/II) combined with the more recent Halogen Occultation Experiment (HALOE) observations provide evidence of a slowdown in stratospheric ozone losses since 1997. This evidence is quantified by the cumulative sum of residual differences from the predicted linear trend. The cumulative residuals indicate that the rate of ozone loss at 35- 45 km altitudes globally has diminished. These changes in loss rates are consistent with the slowdown of total stratospheric chlorine increases characterized by HALOE HCI measurements. These changes in the ozone loss rates in the upper stratosphere are significant and constitute the first stage of a recovery of the ozone layer.

Validation of the 12-gene colon cancer recurrence score as a predictor of recurrence risk in stage II and III rectal cancer patients.

PubMed

Reimers, Marlies S; Kuppen, Peter J K; Lee, Mark; Lopatin, Margarita; Tezcan, Haluk; Putter, Hein; Clark-Langone, Kim; Liefers, Gerrit Jan; Shak, Steve; van de Velde, Cornelis J H

2014-11-01

The 12-gene Recurrence Score assay is a validated predictor of recurrence risk in stage II and III colon cancer patients. We conducted a prospectively designed study to validate this assay for prediction of recurrence risk in stage II and III rectal cancer patients from the Dutch Total Mesorectal Excision (TME) trial. RNA was extracted from fixed paraffin-embedded primary rectal tumor tissue from stage II and III patients randomized to TME surgery alone, without (neo)adjuvant treatment. Recurrence Score was assessed by quantitative real time-polymerase chain reaction using previously validated colon cancer genes and algorithm. Data were analysed by Cox proportional hazards regression, adjusting for stage and resection margin status. All statistical tests were two-sided. Recurrence Score predicted risk of recurrence (hazard ratio [HR] = 1.57, 95% confidence interval [CI] = 1.11 to 2.21, P = .01), risk of distant recurrence (HR = 1.50, 95% CI = 1.04 to 2.17, P = .03), and rectal cancer-specific survival (HR = 1.64, 95% CI = 1.15 to 2.34, P = .007). The effect of Recurrence Score was most prominent in stage II patients and attenuated with more advanced stage (P(interaction) ≤ .007 for each endpoint). In stage II, five-year cumulative incidence of recurrence ranged from 11.1% in the predefined low Recurrence Score group (48.5% of patients) to 43.3% in the high Recurrence Score group (23.1% of patients). The 12-gene Recurrence Score is a predictor of recurrence risk and cancer-specific survival in rectal cancer patients treated with surgery alone, suggesting a similar underlying biology in colon and rectal cancers. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Phase II design with sequential testing of hypotheses within each stage.

PubMed

Poulopoulou, Stavroula; Karlis, Dimitris; Yiannoutsos, Constantin T; Dafni, Urania

2014-01-01

The main goal of a Phase II clinical trial is to decide, whether a particular therapeutic regimen is effective enough to warrant further study. The hypothesis tested by Fleming's Phase II design (Fleming, 1982) is [Formula: see text] versus [Formula: see text], with level [Formula: see text] and with a power [Formula: see text] at [Formula: see text], where [Formula: see text] is chosen to represent the response probability achievable with standard treatment and [Formula: see text] is chosen such that the difference [Formula: see text] represents a targeted improvement with the new treatment. This hypothesis creates a misinterpretation mainly among clinicians that rejection of the null hypothesis is tantamount to accepting the alternative, and vice versa. As mentioned by Storer (1992), this introduces ambiguity in the evaluation of type I and II errors and the choice of the appropriate decision at the end of the study. Instead of testing this hypothesis, an alternative class of designs is proposed in which two hypotheses are tested sequentially. The hypothesis [Formula: see text] versus [Formula: see text] is tested first. If this null hypothesis is rejected, the hypothesis [Formula: see text] versus [Formula: see text] is tested next, in order to examine whether the therapy is effective enough to consider further testing in a Phase III study. For the derivation of the proposed design the exact binomial distribution is used to calculate the decision cut-points. The optimal design parameters are chosen, so as to minimize the average sample number (ASN) under specific upper bounds for error levels. The optimal values for the design were found using a simulated annealing method.

Characteristics and outcome of stage II and III non-anaplastic Wilms' tumour treated according to the SIOP trial and study 93-01.

PubMed

Graf, Norbert; van Tinteren, Harm; Bergeron, Christophe; Pein, François; van den Heuvel-Eibrink, Marry M; Sandstedt, Bengt; Schenk, Jens-Peter; Godzinski, Jan; Oldenburger, Foppe; Furtwängler, Rhoikos; de Kraker, Jan

2012-11-01

To determine the prognosis of children with stage II and III of low or intermediate risk histology (SIOP classification) in unilateral localised Wilms tumour (WT) after neoadjuvant chemotherapy according to the trial and study of the International Society of Paediatric Oncology, SIOP 93-01. Patients with unilateral localised WT and stage II or III with low (LR) or intermediate risk (IR) histology between 6 months and 18 years of age, were selected from the total sample of patients registered in the SIOP 93-01 study between June 1993 and December 2001. All patients received 4 weeks of actinomycin-D/vincristine before surgery. Postoperative chemotherapy consisted of actinomycin-D, vincristine and epirubicin/doxorubicin for 27 weeks. Flank or whole abdomen irradiation was given for stage III. Event-free survival (EFS) and overall survival (OS) were analysed for various subgroups. Of 1476 registered patients 594 (40%) met the inclusion criteria for this analysis. Four hundred and two (67%) had stage II disease and 563 (95%) had intermediate risk histology. Median tumour volume was 439 ml at diagnosis and 163 ml after preoperative chemotherapy. With a median follow-up of 8 years, 5-year EFS was 90% (95% confidence interval [95% CI]: 87-92%) and OS 95% (95% CI: 93-97%). Patients with stage III, blastemal type histology and a large volume at surgery had a worse outcome. Treatment for stage II and III LR or IR WT is successful in a neoadjuvant setting as advised by the SIOP. Stage, tumour volume and blastemal type histology are the most important prognostic factors. Copyright © 2012 Elsevier Ltd. All rights reserved.

Activity monitoring reflects cardiovascular and metabolic variations in COPD patients across GOLD stages II to IV.

PubMed

Kortianou, E A; Louvaris, Z; Vasilopoulou, M; Nasis, I; Kaltsakas, G; Koulouris, N G; Vogiatzis, I

2013-12-01

We investigated whether activity monitoring reliably reflects variations in oxygen transport and utilization during walking in COPD patients. Forty-two patients (14 in each GOLD stage II, III and IV) performed an incremental treadmill protocol to the limit of tolerance. Breath-by-breath gas exchange, central hemodynamic variables and activity monitoring were simultaneously recorded. Physiological variables and accelerometer outputs rose linearly with walking speeds. Strong correlations (r[interquartile range, IQR]) were found between treadmill walking intensity (WI: range 0.8-2.0 ms(-2)) and oxygen consumption (0.95 [IQR 0.87-0.97]), (range 7.6-15.5 ml kg(-1)min(-1)); minute ventilation (0.95 [IQR 0.86-0.98]), (range 20-37 l min(-1)); cardiac output (0.89 [IQR 0.73-0.94]), (range 6.8-11.5 l min(-1)) and arteriovenous oxygen concentration difference (0.84 [IQR 0.76-0.90]), (range 7.7-12.1 ml O2100 ml(-1)). Correlations between WI and gas exchange or central hemodynamic parameters were not different across GOLD stages. In conclusion, central hemodynamic, respiratory and muscle metabolic variations during incremental treadmill exercise are tightly associated to changes in walking intensity as recorded by accelerometry across GOLD stages II to IV. Interestingly, the magnitude of these associations is not different across GOLD stages. Copyright © 2013 Elsevier B.V. All rights reserved.

Artist concept of Galileo with inertial upper stage (IUS) in low Earth orbit

NASA Image and Video Library

1989-08-25

S89-42940 (April 1989) --- In this artist's rendition, the Galileo spacecraft is being boosted into its inter-planetary trajectory by the Inertial Upper Stage (IUS) rocket. The Space Shuttle Atlantis, which is scheduled to take Galileo and the IUS from Earth's surface into space, is depicted against the curve of Earth. Galileo will be placed on a trajectory to Venus, from which it will return to Earth at higher velocity and then gain still more energy in two gravity-assist passes, until it has enough velocity to reach Jupiter. Passing Venus, it will take scientific data using instruments designed for observing Jupiter; later, it will make measurements at Earth and the moon, crossing above the moon's north pole in the second pass. Between the two Earth passes, it will edge into the asteroid belt, beyond Mars' orbit; there, the first close-up observation of an asteroid is planned. Crossing the belt later, another asteroid flyby is possible.

Granisetron, Aprepitant, and Dexamethasone in Preventing Nausea and Vomiting in Patients Receiving Chemotherapy for Stage II, III, or IV Ovarian Cancer

ClinicalTrials.gov

2018-04-24

Nausea and Vomiting; Ovarian Brenner Tumor; Ovarian Clear Cell Cystadenocarcinoma; Ovarian Endometrioid Adenocarcinoma; Ovarian Mucinous Cystadenocarcinoma; Ovarian Seromucinous Carcinoma; Ovarian Serous Cystadenocarcinoma; Stage II Ovarian Cancer; Stage IIA Fallopian Tube Cancer; Stage IIA Ovarian Cancer; Stage IIB Fallopian Tube Cancer; Stage IIB Ovarian Cancer; Stage IIC Fallopian Tube Cancer; Stage IIC Ovarian Cancer; Stage IIIA Fallopian Tube Cancer; Stage IIIA Ovarian Cancer; Stage IIIA Primary Peritoneal Cancer; Stage IIIB Fallopian Tube Cancer; Stage IIIB Ovarian Cancer; Stage IIIB Primary Peritoneal Cancer; Stage IIIC Fallopian Tube Cancer; Stage IIIC Ovarian Cancer; Stage IIIC Primary Peritoneal Cancer; Stage IV Fallopian Tube Cancer; Stage IV Ovarian Cancer; Stage IV Primary Peritoneal Cancer; Undifferentiated Ovarian Carcinoma

Advanced space engine preliminary design. [liquid hydrogen/liquid oxygen upper stage engine for space tug application

NASA Technical Reports Server (NTRS)

Zachary, A. T.

1973-01-01

Analysis and design of an optimum LO2/LH2, combustion topping cycle, 88,964 Newtons (20,000-pound) thrust, liquid rocket engine was conducted. The design selected is well suited to high-energy, upper-stage engine applications such as the Space Tug and embodies features directed toward optimization of vehicle performance. A configuration selection was conducted based on prior Air Force Contracts, and additional criteria for optimum stage performance. Following configuration selection, analyses and design of the major components and engine systems were conducted to sufficient depth to provide layout drawings suitable for subsequent detailing. In addition, engine packaging to a common interface and a retractable nozzle concept were defined. Alternative development plans and related costs were also established. The design embodies high-performance, low-weight, low NPSH requirements (saturated propellant inlet conditions at start), idle-mode operation, and autogenous pressurization. The design is the result of the significant past and current LO2/LH2 technology efforts of the NASA centers and the Air Force, as well as company-funded programs.

Carboplatin and Paclitaxel With or Without Atezolizumab Before Surgery in Treating Patients With Newly Diagnosed, Stage II-III Triple-Negative Breast Cancer

ClinicalTrials.gov

2018-06-08

Estrogen Receptor Negative; HER2/Neu Negative; Invasive Breast Carcinoma; Progesterone Receptor Negative; Stage II Breast Cancer AJCC v6 and v7; Stage IIA Breast Cancer AJCC v6 and v7; Stage IIB Breast Cancer AJCC v6 and v7; Stage III Breast Cancer AJCC v7; Stage IIIA Breast Cancer AJCC v7; Stage IIIB Breast Cancer AJCC v7; Stage IIIC Breast Cancer AJCC v7; Triple-Negative Breast Carcinoma

Comprehensive Approach to Pupil Planning: Stage II - Planning and Placement (Includes Planning and Placement Team Meeting Agenda). Experimental Edition.

ERIC Educational Resources Information Center

Vlasak, Frances Stetson; Kaufman, Martin J.

Presented is Stage II of the Comprehensive Approach to Pupil Planning (CAPP) System, a three-stage model for planning educational interventions in the regular and special education classrooms and for guiding placement decisions. The guide focuses on the evaluation services performed by the Planning and Placement Team (PPT) with sections on the…

Cetuximab, Cisplatin, and Radiation Therapy in Treating Patients With Stage IB, Stage II, Stage III, or Stage IVA Cervical Cancer

ClinicalTrials.gov

2014-12-29

Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Small Cell Carcinoma; Cervical Squamous Cell Carcinoma; Stage IB Cervical Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage III Cervical Cancer; Stage IVA Cervical Cancer

Genes associated with metabolic syndrome predict disease-free survival in stage II colorectal cancer patients. A novel link between metabolic dysregulation and colorectal cancer.

PubMed

Vargas, Teodoro; Moreno-Rubio, Juan; Herranz, Jesús; Cejas, Paloma; Molina, Susana; González-Vallinas, Margarita; Ramos, Ricardo; Burgos, Emilio; Aguayo, Cristina; Custodio, Ana B; Reglero, Guillermo; Feliu, Jaime; Ramírez de Molina, Ana

2014-12-01

Studies have recently suggested that metabolic syndrome and its components increase the risk of colorectal cancer. Both diseases are increasing in most countries, and the genetic association between them has not been fully elucidated. The objective of this study was to assess the association between genetic risk factors of metabolic syndrome or related conditions (obesity, hyperlipidaemia, diabetes mellitus type 2) and clinical outcome in stage II colorectal cancer patients. Expression levels of several genes related to metabolic syndrome and associated alterations were analysed by real-time qPCR in two equivalent but independent sets of stage II colorectal cancer patients. Using logistic regression models and cross-validation analysis with all tumour samples, we developed a metabolic syndrome-related gene expression profile to predict clinical outcome in stage II colorectal cancer patients. The results showed that a gene expression profile constituted by genes previously related to metabolic syndrome was significantly associated with clinical outcome of stage II colorectal cancer patients. This metabolic profile was able to identify patients with a low risk and high risk of relapse. Its predictive value was validated using an independent set of stage II colorectal cancer patients. The identification of a set of genes related to metabolic syndrome that predict survival in intermediate-stage colorectal cancer patients allows delineation of a high-risk group that may benefit from adjuvant therapy and avoid the toxic and unnecessary chemotherapy in patients classified as low risk. Our results also confirm the linkage between metabolic disorder and colorectal cancer and suggest the potential for cancer prevention and/or treatment by targeting these genes. Copyright © 2014 Federation of European Biochemical Societies. Published by Elsevier B.V. All rights reserved.

Effects of the AirLift PTTD brace on foot kinematics in subjects with stage II posterior tibial tendon dysfunction.

PubMed

Neville, Christopher; Flemister, A Samuel; Houck, Jeff R

2009-03-01

Experimental laboratory study. To investigate the effect of inflation of the air bladder component of the AirLift PTTD brace on relative foot kinematics in subjects with stage II posterior tibial tendon dysfunction (PTTD). Orthotic devices are commonly recommended in the conservative management of stage II PTTD to improve foot kinematics. Ten female subjects with stage II PTTD walked in the laboratory wearing the AirLift PTTD brace during 3 testing conditions (air bladder inflation to 0, 4, and 7 PSI [SI equivalent: 0, 27,579, and 48,263 Pa]). Kinematics were recorded from the tibia, calcaneus (hindfoot), and first metatarsal (forefoot), using an Optotrak motion analysis system. Comparisons were made between air bladder inflation and the 0-PSI condition for each of the dependent kinematic variables (hindfoot eversion, forefoot abduction, and forefoot dorsiflexion). Greater hindfoot inversion was observed with air bladder inflation during the second rocker (mean, 1.7 degrees; range, -0.7 degrees to 6.1 degrees). Less consistent changes in forefoot plantar flexion and forefoot adduction occurred with air bladder inflation. The greatest change toward forefoot plantar flexion was observed during the third rocker (mean, 1.4 degrees; range, -3.8 degrees to 3.9 degrees). The greatest change towards adduction was observed during the third rocker (mean, 2.3 degrees; range, -3.4 degrees to 6.5 degrees). On average, the air bladder component of the AirLift PTTD brace was successful in reducing the amount of hindfoot eversion observed in subjects with stage II PTTD; however, the effect on forefoot motion was more variable. Some subjects tested had marked improvement in foot kinematics, while 2 subjects demonstrated negative results. Specific foot characteristics are hypothesized to explain these varied results.

Two stage sorption type cryogenic refrigerator including heat regeneration system

NASA Technical Reports Server (NTRS)

Jones, Jack A. (Inventor); Wen, Liang-Chi (Inventor); Bard, Steven (Inventor)

1989-01-01

A lower stage chemisorption refrigeration system physically and functionally coupled to an upper stage physical adsorption refrigeration system is disclosed. Waste heat generated by the lower stage cycle is regenerated to fuel the upper stage cycle thereby greatly improving the energy efficiency of a two-stage sorption refrigerator. The two stages are joined by disposing a first pressurization chamber providing a high pressure flow of a first refrigerant for the lower stage refrigeration cycle within a second pressurization chamber providing a high pressure flow of a second refrigerant for the upper stage refrigeration cycle. The first pressurization chamber is separated from the second pressurization chamber by a gas-gap thermal switch which at times is filled with a thermoconductive fluid to allow conduction of heat from the first pressurization chamber to the second pressurization chamber.

77 FR 28772 - Air Quality: Widespread Use for Onboard Refueling Vapor Recovery and Stage II Waiver

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-16

... required emissions control measure in Serious, Severe, and Extreme ozone nonattainment areas. Beginning... control on nearly all new highway vehicles since 2006. Over time, non- ORVR vehicles will continue to be replaced with ORVR vehicles. Stage II and ORVR emission control systems are redundant, and the EPA has...

Methylation of WNT target genes AXIN2 and DKK1 as robust biomarkers for recurrence prediction in stage II colon cancer

PubMed Central

Kandimalla, R; Linnekamp, J F; van Hooff, S; Castells, A; Llor, X; Andreu, M; Jover, R; Goel, A; Medema, J P

2017-01-01

Stage II colon cancer (CC) still remains a clinical challenge with patient stratification for adjuvant therapy (AT) largely relying on clinical parameters. Prognostic biomarkers are urgently needed for better stratification. Previously, we have shown that WNT target genes AXIN2, DKK1, APCDD1, ASCL2 and LGR5 are silenced by DNA methylation and could serve as prognostic markers in stage II CC patients using methylation-specific PCR. Here, we have extended our discovery cohort AMC90-AJCC-II (N=65) and methylation was analyzed by quantitative pyrosequencing. Subsequently, we validated the results in an independent EPICOLON1 CC cohort (N=79). Methylation of WNT target genes is negatively correlated to mRNA expression. A combination of AXIN2 and DKK1 methylation significantly predicted recurrences in univariate (area under the curve (AUC)=0.83, confidence interval (CI): 0.72–0.94, P<0.0001) analysis in stage II microsatellite stable (MSS) CC patients. This two marker combination showed an AUC of 0.80 (CI: 0.68–0.91, P<0.0001) in the EPICOLON1 validation cohort. Multivariate analysis in the Academic Medical Center (AMC) cohort revealed that both WNT target gene methylation and consensus molecular subtype 4 (CMS4) are significantly associated with poor recurrence-free survival (hazard ratio (HR)methylation: 3.84, 95% CI: 1.14–12.43; HRCMS4: 3.73, 95% CI: 1.22–11.48). CMS4 subtype tumors with WNT target methylation showed worse prognosis. Combining WNT target gene methylation and CMS4 subtype lead to an AUC of 0.89 (0.791–0.982, P<0.0001) for recurrence prediction. Notably, we observed that methylation of DKK1 is high in BRAF mutant and CIMP (CpG island methylator phenotype)-positive cancers, whereas AXIN2 methylation appears to be associated with CMS4. Methylation of AXIN2 and DKK1 were found to be robust markers for recurrence prediction in stage II MSS CC patients. Further validation of these findings in a randomized and prospective manner could pave a way to

A prospective study evaluating the Pressure Ulcer Scale for Healing (PUSH Tool) to assess stage II, stage III, and stage IV pressure ulcers.

PubMed

Günes, Ulkü Yapucu

2009-05-01

Many valid and reliable tools and techniques are available for wound measurement. However, few prospective clinical studies assessing these instruments have been conducted. A prospective, methodological study was conducted between September 2006 and November 2007 to evaluate use of the Pressure Ulcer Scale for Healing (PUSH) version 3 in patients with one or more pressure ulcer. A convenience sample of 72 persons (mean age 66.9 +/- 12.8 years) with 86 pressure ulcers (49% Stage II, 47% Stage III, and 4% Stage IV) was recruited and assessed weekly until healing, transfer, patient death, or end of study for a maximum of 8 weeks. Most ulcers (77%) were in the sacral area and 56% had been present for 1 month or longer. Repeated measures analysis revealed that PUSH total scores decreased significantly (P < 0.001) over the 8-week study, with significant differences in PUSH total scores between healed and unhealed ulcers each week, starting on week 1. The total PUSH score as well as the length x width item in the tool accurately differentiated between healed and nonhealed ulcers. Although the PUSH tool is practical, easy-to-use, and generally sensitive to change, some modifications would improve its value--ie, a wound size/depth subscale. Additional studies to help clinicians more accurately evaluate the effectiveness of their interventions, including studies to determine whether wound measurements alone may suffice to monitor healing, are needed.

Profiling MHC II immunopeptidome of blood-stage malaria reveals that cDC1 control the functionality of parasite-specific CD4 T cells.

PubMed

Draheim, Marion; Wlodarczyk, Myriam F; Crozat, Karine; Saliou, Jean-Michel; Alayi, Tchilabalo Dilezitoko; Tomavo, Stanislas; Hassan, Ali; Salvioni, Anna; Demarta-Gatsi, Claudia; Sidney, John; Sette, Alessandro; Dalod, Marc; Berry, Antoine; Silvie, Olivier; Blanchard, Nicolas

2017-11-01

In malaria, CD4 Th1 and T follicular helper (T FH ) cells are important for controlling parasite growth, but Th1 cells also contribute to immunopathology. Moreover, various regulatory CD4 T-cell subsets are critical to hamper pathology. Yet the antigen-presenting cells controlling Th functionality, as well as the antigens recognized by CD4 T cells, are largely unknown. Here, we characterize the MHC II immunopeptidome presented by DC during blood-stage malaria in mice. We establish the immunodominance hierarchy of 14 MHC II ligands derived from conserved parasite proteins. Immunodominance is shaped differently whether blood stage is preceded or not by liver stage, but the same ETRAMP-specific dominant response develops in both contexts. In naïve mice and at the onset of cerebral malaria, CD8α + dendritic cells (cDC1) are superior to other DC subsets for MHC II presentation of the ETRAMP epitope. Using in vivo depletion of cDC1, we show that cDC1 promote parasite-specific Th1 cells and inhibit the development of IL-10 + CD4 T cells. This work profiles the P. berghei blood-stage MHC II immunopeptidome, highlights the potency of cDC1 to present malaria antigens on MHC II, and reveals a major role for cDC1 in regulating malaria-specific CD4 T-cell responses. © 2017 The Authors. Published under the terms of the CC BY 4.0 license.

A prognostic mutation panel for predicting cancer recurrence in stages II and III colorectal cancer.

PubMed

Sho, Shonan; Court, Colin M; Winograd, Paul; Russell, Marcia M; Tomlinson, James S

2017-12-01

Approximately 20-40% of stage II/III colorectal cancer (CRC) patients develop relapse. Clinicopathological factors alone are limited in detecting these patients, resulting in potential under/over-treatment. We sought to identify a prognostic tumor mutational profile that could predict CRC recurrence. Whole-exome sequencing data were obtained for 207 patients with stage II/III CRC from The Cancer Genome Atlas. Mutational landscape in relapse-free versus relapsed cohort was compared using Fisher's exact test, followed by multivariate Cox regression to identify genes associated with cancer recurrence. Bootstrap-validation was used to examine internal/external validity. We identified five prognostic genes (APAF1, DIAPH2, NTNG1, USP7, and VAV2), which were combined to form a prognostic mutation panel. Patients with ≥1 mutation(s) within this five-gene panel had worse prognosis (3-yr relapse-free survival [RFS]: 53.0%), compared to patients with no mutation (3-yr RFS: 84.3%). In multivariate analysis, the five-gene panel remained prognostic for cancer recurrence independent of stage and high-risk features (hazard ratio 3.63, 95%CI [1.93-6.83], P < 0.0001). Furthermore, its prognostic accuracy was superior to the American Joint Commission on Cancer classification (concordance-index: 0.70 vs 0.54). Our proposed mutation panel identifies CRC patients at high-risk for recurrence, which may help guide adjuvant therapy and post-operative surveillance protocols. © 2017 Wiley Periodicals, Inc.

Recurrence patterns and survival endpoints in women with stage II uterine endometrioid carcinoma: a multi-institution study.

PubMed

Elshaikh, Mohamed A; Al-Wahab, Zaid; Mahdi, Haider; Albuquerque, Kevin; Mahan, Meredith; Kehoe, Siobhan M; Ali-Fehmi, Rouba; Rose, Peter G; Munkarah, Adnan R

2015-02-01

There is paucity of data in regard to prognostic factors and outcome of women with 2009 FIGO stage II disease. The objective of this study was to investigate prognostic factors, recurrence patterns and survival endpoints in this group of patients. Data from four academic institutions were analyzed. 130 women were identified with 2009 FIGO stage II. All patients underwent hysterectomy, oophorectomy and lymph node evaluation with or without pelvic and paraaortic lymph node dissections and peritoneal cytology. The Kaplan-Meier approach and Cox regression analysis were used to estimate recurrence-free (RFS), disease-specific (DSS) and overall survival (OS). Median follow-up was 44months. 120 patients (92%) underwent simple hysterectomy, 78% had lymph node dissection and 95% had peritoneal cytology examination. 99 patients (76%) received adjuvant radiation treatment (RT). 5-year RFS, DSS and OS were 77%, 90%, and 72%, respectively. On multivariate analysis of RFS, adjuvant RT, the presence of lymphovascular space invasion (LVSI) and high tumor grades were significant predictors. For DSS, LVSI and high tumor grades were significant predictors while older age and high tumor grade were the only predictors of OS. In this multi-institutional study, disease-specific survival for women with FIGO stage II uterine endometrioid carcinoma is excellent. High tumor grade, lymphovascular space invasion, adjuvant radiation treatment and old age are important prognostic factors. There was no significant difference in the outcome between patients who received vaginal cuff brachytherapy compared to those who received pelvic external beam radiation treatment. Copyright © 2014 Elsevier Inc. All rights reserved.

Distribution of early life history stages of fishes in selected pools of the upper Mississippi River

USGS Publications Warehouse

Holland, L.E.

1986-01-01

Effective management of the fishery resources of the Upper Mississippi River and successful mitigation of the loss of critical habitat depend in part on an understanding of the reproductive and early life history requirements of the affected fishes. However, little is known about the use of nursery areas by fishes in the river. Of the nearly 130 species identified in the adult ichthyofauna, only a few are represented proportionally in the available data on early life stages because study designs have not included consideration of the early stages, collection gears have not adequately sampled the young, and eggs and larvae of some species are difficult to sample by conventional approaches. For the species collected, information is available on seasonal variations in total densities, composition, and catch among different habitat types. However, the data are most accurate for species with buoyant early life stages, such as freshwater drum (Aplodinotus grunniens) and gizzard shad (Dorosoma cepedianum). Eggs and larvae of freshwater drum dominate collections made in the main channel, whereas other larval fishes are usually most abundant in backwater habitats. The species found there usually deposit eggs on the substrate or on vegetation. Habitat preferences (as indicated by relative abundance) often shift as development proceeds and physical and behavioral changes occur in the larvae. Only limited information is available on the distribution of larvae within habitats, but it is clear that variations within habitats are significant.

Computer program for post-flight evaluation of a launch vehicle upper-stage on-off reaction control system

NASA Technical Reports Server (NTRS)

Knauber, R. N.

1982-01-01

This report describes a FORTRAN IV coded computer program for post-flight evaluation of a launch vehicle upper stage on-off reaction control system. Aerodynamic and thrust misalignment disturbances are computed as well as the total disturbing moments in pitch, yaw, and roll. Effective thrust misalignment angle time histories of the rocket booster motor are calculated. Disturbing moments are integrated and used to estimate the required control system total inpulse. Effective control system specific inpulse is computed for the boost and coast phases using measured control fuel useage. This method has been used for more than fifteen years for analyzing the NASA Scout launch vehicle second and third-stage reaction control system performance. The computer program is set up in FORTRAN IV for a CDC CYBER 175 system. With slight modification it can be used on other machines having a FORTRAN compiler. The program has optional CALCOMP plotting output. With this option the program requires 19K words of memory and has 786 cards. Running time on a CDC CYBER 175 system is less than three (3) seconds for a typical problem.

Thymidine phosphorylase and hypoxia-inducible factor 1-α expression in clinical stage II/III rectal cancer: association with response to neoadjuvant chemoradiation therapy and prognosis.

PubMed

Lin, Shuhan; Lai, Hao; Qin, Yuzhou; Chen, Jiansi; Lin, Yuan

2015-01-01

The aim of this study was to determine whether pretreatment status of thymidine phosphorylase (TP), and hypoxia-inducible factor alpha (HIF-1α) could predict pathologic response to neoadjuvant chemoradiation therapy with oxaliplatin and capecitabine (XELOXART) and outcomes for clinical stage II/III rectal cancer patients. A total of 180 patients diagnosed with clinical stage II/III rectal cancer received XELOXART. The status of TP, and HIF-1α were determined in pretreatment biopsies by immunohistochemistry (IHC). Tumor response was assessed in resected regimens using the tumor regression grade system and TNM staging system. 5-year disease free survival (DFS) and 5-year overall survival (OS) were evaluated with the Kaplan-Meier method and were compared by the log-rank test. Over expression of TP and low expression of HIF-1α were associated with pathologic response to XELOXART and better outcomes (DFS and OS) in clinical stage II/III rectal cancer patients (P < 0.05). Our result suggested that pretreatment status of TP and HIF-1α were found to predict pathologic response and outcomes in clinical stage II/III rectal cancer received XELOXART. Additional well-designed, large sample, multicenter, prospective studies are needed to confirm the result of this study.

A robust two-stage design identifying the optimal biological dose for phase I/II clinical trials.

PubMed

Zang, Yong; Lee, J Jack

2017-01-15

We propose a robust two-stage design to identify the optimal biological dose for phase I/II clinical trials evaluating both toxicity and efficacy outcomes. In the first stage of dose finding, we use the Bayesian model averaging continual reassessment method to monitor the toxicity outcomes and adopt an isotonic regression method based on the efficacy outcomes to guide dose escalation. When the first stage ends, we use the Dirichlet-multinomial distribution to jointly model the toxicity and efficacy outcomes and pick the candidate doses based on a three-dimensional volume ratio. The selected candidate doses are then seamlessly advanced to the second stage for dose validation. Both toxicity and efficacy outcomes are continuously monitored so that any overly toxic and/or less efficacious dose can be dropped from the study as the trial continues. When the phase I/II trial ends, we select the optimal biological dose as the dose obtaining the minimal value of the volume ratio within the candidate set. An advantage of the proposed design is that it does not impose a monotonically increasing assumption on the shape of the dose-efficacy curve. We conduct extensive simulation studies to examine the operating characteristics of the proposed design. The simulation results show that the proposed design has desirable operating characteristics across different shapes of the underlying true dose-toxicity and dose-efficacy curves. The software to implement the proposed design is available upon request. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Ibrutinib, Rituximab, Etoposide, Prednisone, Vincristine Sulfate, Cyclophosphamide, and Doxorubicin Hydrochloride in Treating Patients With HIV-Positive Stage II-IV Diffuse Large B-Cell Lymphomas

ClinicalTrials.gov

2018-06-11

AIDS-Related Lymphoma; Ann Arbor Stage II Diffuse Large B-Cell Lymphoma; Ann Arbor Stage III Diffuse Large B-Cell Lymphoma; Ann Arbor Stage IV Diffuse Large B-Cell Lymphoma; CD20 Negative; CD20 Positive; Human Immunodeficiency Virus Positive

The drama of the continuous increase in end-stage renal failure in patients with type II diabetes mellitus.

PubMed

Rychlík, I; Miltenberger-Miltenyi, G; Ritz, E

1998-01-01

Type II diabetes mellitus has become the leading cause of end-stage renal failure in many countries of Western Europe. In all European countries, even in those with a relatively low prevalence of diabetic nephropathy, the number of patients with type II diabetes mellitus admitted for renal replacement therapy has recently increased continuously. Survival and medical rehabilitation of patients with type II diabetes on renal replacement therapy is significantly worse than in non-diabetic patients. It is obvious that in order to stem the tide, intense efforts are necessary (i) to inform the medical community about the renal risk of type II diabetes and the striking effectiveness of preventive measures, (ii) to provide better care for diabetic patients, and (iii) to reduce the high prevalence of diabetes in the population by modification of the Western life style.

Dose to heart substructures is associated with non-cancer death after SBRT in stage I-II NSCLC patients.

PubMed

Stam, Barbara; Peulen, Heike; Guckenberger, Matthias; Mantel, Frederick; Hope, Andrew; Werner-Wasik, Maria; Belderbos, Jose; Grills, Inga; O'Connell, Nicolette; Sonke, Jan-Jakob

2017-06-01

To investigate potential associations between dose to heart (sub)structures and non-cancer death, in early stage non-small cell lung cancer (NSCLC) patients treated with stereotactic body radiation therapy (SBRT). 803 patients with early stage NSCLC received SBRT with predominant schedules of 3×18Gy (59%) or 4×12Gy (19%). All patients were registered to an average anatomy, their planned dose deformed accordingly, and dosimetric parameters for heart substructures were obtained. Multivariate Cox regression and a sensitivity analysis were used to identify doses to heart substructures or heart region with a significant association with non-cancer death respectively. Median follow-up was 34.8months. Two year Kaplan-Meier overall survival rate was 67%. Of the deceased patients, 26.8% died of cancer. Multivariate analysis showed that the maximum dose on the left atrium (median 6.5Gy EQD2, range=0.009-197, HR=1.005, p-value=0.035), and the dose to 90% of the superior vena cava (median 0.59Gy EQD2, range=0.003-70, HR=1.025, p-value=0.008) were significantly associated with non-cancer death. Sensitivity analysis identified the upper region of the heart (atria+vessels) to be significantly associated with non-cancer death. Doses to mainly the upper region of the heart were significantly associated with non-cancer death. Consequently, dose sparing in particular of the upper region of the heart could potentially improve outcome, and should be further studied. Copyright © 2017 Elsevier B.V. All rights reserved.

A 20k Payload Launch Vehicle Fast Track Development Concept Using an RD-180 Engine and a Centaur Upper Stage

NASA Technical Reports Server (NTRS)

Toelle, Ronald (Compiler)

1995-01-01

A launch vehicle concept to deliver 20,000 lb of payload to a 100-nmi orbit has been defined. A new liquid oxygen/kerosene booster powered by an RD-180 engine was designed while using a slightly modified Centaur upper stage. The design, development, and test program met the imposed 40-mo schedule by elimination of major structural testing by increased factors of safety and concurrent engineering concepts. A growth path to attain 65,000 lb of payload is developed.

Rituximab and Oblimersen in Treating Patients With Stage II, Stage III, or Stage IV Follicular Non-Hodgkin's Lymphoma

ClinicalTrials.gov

2013-01-04

Stage III Grade 1 Follicular Lymphoma; Stage III Grade 2 Follicular Lymphoma; Stage III Grade 3 Follicular Lymphoma; Stage IV Grade 1 Follicular Lymphoma; Stage IV Grade 2 Follicular Lymphoma; Stage IV Grade 3 Follicular Lymphoma

The prognostic value of polycomb group protein B-cell-specific moloney murine leukemia virus insertion site 1 in stage II colon cancer patients.

PubMed

Espersen, Maiken L M; Linnemann, Dorte; Christensen, Ib J; Alamili, Mahdi; Troelsen, Jesper T; Høgdall, Estrid

2016-07-01

The aim of this study was to investigate the prognostic value of B-cell-specific moloney murine leukemia virus insertion site 1 (BMI1) protein expression in primary tumors of stage II colon cancer patients. BMI1 protein expression was assessed by immunohistochemistry in a retrospective patient cohort consisting of 144 stage II colon cancer patients. BMI1 expression at the invasive front of the primary tumors correlated with mismatch repair status of the tumors. Furthermore, BMI1 expression at the luminal surface correlated with T-stage, tumor location, and the histological subtypes of the tumors. In a univariate Cox proportional hazard analysis, no statistical significant association between risk of relapse and BMI1 protein expression at the invasive front (HR: 1.12; 95% CI 0.78-1.60; p = 0.53) or at the luminal surface of the tumor (HR: 1.06; 95% CI 0.75-1.48; p = 0.70) was found. Likewise, there was no association between 5-year overall survival and BMI1 expression at the invasive front (HR: 1.12; 95% CI 0.80-1.56; p = 0.46) or at the luminal surface of the tumor (HR: 1.16; 95% CI 0.86-1.60; p = 0.33). In conclusion, BMI1 expression in primary tumors of stage II colon cancer patients could not predict relapse or overall survival of the patients, thus having a limited prognostic value in stage II colon cancer patients. © 2016 APMIS. Published by John Wiley & Sons Ltd.

Comparison of Outcomes After Fluorouracil-Based Adjuvant Therapy for Stages II and III Colon Cancer Between 1978 to 1995 and 1996 to 2007: Evidence of Stage Migration From the ACCENT Database

PubMed Central

Shi, Qian; Andre, Thierry; Grothey, Axel; Yothers, Greg; Hamilton, Stanley R.; Bot, Brian M.; Haller, Daniel G.; Van Cutsem, Eric; Twelves, Chris; Benedetti, Jacqueline K.; O'Connell, Michael J.; Sargent, Daniel J.

2013-01-01

Purpose With improved patient care, better diagnosis, and more treatment options after tumor recurrence, outcomes after fluorouracil (FU) -based treatment are expected to have improved over time in early-stage colon cancer. Data from 18,449 patients enrolled onto 21 phase III trials conducted from 1978 to 2002 were evaluated for potential differences in time to recurrence (TTR), time from recurrence to death (TRD), and overall survival (OS) with regard to FU-based adjuvant regimens. Methods Trials were predefined as old versus newer era using initial accrual before or after 1995. Outcomes were compared between patients enrolled onto old- or newer-era trials, stratified by stage. Results Within the first 3 years, recurrence rates were lower in newer- versus old-era trials for patients with stage II disease, with no differences among those with stage III disease. Both TRD and OS were significantly longer in newer-era trials overall and within each stage. The lymph node (LN) ratio (ie, number of positive nodes divided by total nodes harvested) in those with stage III disease declined over time. TTR improved slightly, with larger number of LNs examined in both stages. Conclusion Improved TRD in newer trials supports the premise that more aggressive intervention (oxaliplatin- and irinotecan-based chemotherapy and/or surgery for recurrent disease) improves OS for patients previously treated in the adjuvant setting. Lower recurrence rates with identical treatments in those with stage II disease enrolled onto newer-era trials reflect stage migration over time, calling into question historical data related to the benefit of FU-based adjuvant therapy in such patients. PMID:23980089

Aktiv De-Orbiting Onboard System from Leo of Upper Stages of Launchers

NASA Astrophysics Data System (ADS)

Trushlyakov, V.; Shalay, V.; Shatrov, J.; Jakovlev, M.; Kostantino, A.

2009-03-01

The active de-orbiting onboard system (VDOS) of upper separable parts (USP) stage of launchers from LEO into orbits of utilization with term of existence orbital lifetimes till 25 years is offered. ADOS it is based on use of power resources of not produced rests of liquid fuel onboard USP launchers with liquid propulsion module (LPM). Following systems enter in structure VDOS: the gas jet propulsion system consisting of a system of gasification, chambers of gas engines (GE), a control system. For gasification of the rests of liquid fuel the heat-carrier received in the autonomous gas generator is used. The gasification propellant components from each tank with temperature and the pressure determined by strength of the corresponding tank, move in chambers of the GE established on a top of a fuel compartment. After separation of a payload execute twist USP for preservation of its position in the space by activity of the GE. Ways of increase of a system effectiveness of gasification are offered by superposition on the entered heat-carrier of ultrasonic oscillations, and also introduction in gaseous fuel nanopowder of aluminum. The volume of adaptations of construction USP, connected with introduction VDOS does not exceed 5 % from weight of a dry construction.

ColoLipidGene: signature of lipid metabolism-related genes to predict prognosis in stage-II colon cancer patients

PubMed Central

Vargas, Teodoro; Moreno-Rubio, Juan; Herranz, Jesús; Cejas, Paloma; Molina, Susana; González-Vallinas, Margarita; Mendiola, Marta; Burgos, Emilio; Aguayo, Cristina; Custodio, Ana B.; Machado, Isidro; Ramos, David; Gironella, Meritxell; Espinosa-Salinas, Isabel; Ramos, Ricardo; Martín-Hernández, Roberto; Risueño, Alberto; De Las Rivas, Javier; Reglero, Guillermo; Yaya, Ricardo; Fernández-Martos, Carlos; Aparicio, Jorge; Maurel, Joan; Feliu, Jaime; de Molina, Ana Ramírez

2015-01-01

Lipid metabolism plays an essential role in carcinogenesis due to the requirements of tumoral cells to sustain increased structural, energetic and biosynthetic precursor demands for cell proliferation. We investigated the association between expression of lipid metabolism-related genes and clinical outcome in intermediate-stage colon cancer patients with the aim of identifying a metabolic profile associated with greater malignancy and increased risk of relapse. Expression profile of 70 lipid metabolism-related genes was determined in 77 patients with stage II colon cancer. Cox regression analyses using c-index methodology was applied to identify a metabolic-related signature associated to prognosis. The metabolic signature was further confirmed in two independent validation sets of 120 patients and additionally, in a group of 264 patients from a public database. The combined analysis of these 4 genes, ABCA1, ACSL1, AGPAT1 and SCD, constitutes a metabolic-signature (ColoLipidGene) able to accurately stratify stage II colon cancer patients with 5-fold higher risk of relapse with strong statistical power in the four independent groups of patients. The identification of a group of 4 genes that predict survival in intermediate-stage colon cancer patients allows delineation of a high-risk group that may benefit from adjuvant therapy, and avoids the toxic and unnecessary chemotherapy in patients classified as low-risk group. PMID:25749516

In Vitro Adenosine Triphosphate-Based Chemotherapy Response Assay as a Predictor of Clinical Response to Fluorouracil-Based Adjuvant Chemotherapy in Stage II Colorectal Cancer

PubMed Central

Kwon, Hye Youn; Kim, Im-kyung; Kang, Jeonghyun; Sohn, Seung-Kook; Lee, Kang Young

2016-01-01

Purpose We evaluated the usefulness of the in vitro adenosine triphosphate-based chemotherapy response assay (ATP-CRA) for prediction of clinical response to fluorouracil-based adjuvant chemotherapy in stage II colorectal cancer. Materials and Methods Tumor specimens of 86 patients with pathologically confirmed stage II colorectal adenocarcinoma were tested for chemosensitivity to fluorouracil. Chemosensitivity was determined by cell death rate (CDR) of drug-exposed cells, calculated by comparing the intracellular ATP level with that of untreated controls. Results Among the 86 enrolled patients who underwent radical surgery followed by fluorouracil-based adjuvant chemotherapy, recurrence was found in 11 patients (12.7%). The CDR ≥ 20% group was associated with better disease-free survival than the CDR < 20% group (89.4% vs. 70.1%, p=0.027). Multivariate analysis showed that CDR < 20% and T4 stage were poor prognostic factors for disease-free survival after fluorouracil-based adjuvant chemotherapy. Conclusion In stage II colorectal cancer, the in vitro ATP-CRA may be useful in identifying patients likely to benefit from fluorouracil-based adjuvant chemotherapy. PMID:26511802

One-stage vs. two-stage BAHA implantation in a pediatric population.

PubMed

Saliba, Issam; Froehlich, Patrick; Bouhabel, Sarah

2012-12-01

BAHA implantation surgery in a pediatric population is usually done in two-stage surgeries. This study aims to evaluate the safety and possible superiority of the one-stage over the two-stage BAHA implantation and which one would be the best standard of care for our pediatric patients. A retrospective chart review of 55 patients operated in our tertiary care institutions between 2005 and 2010 was conducted. The actual tendency in our institutions, applied at the time of the study, is to perform a one-stage surgery for all operated patients (pediatric and adult), except for patients undergoing translabyrinthine surgeries for cerebellopontine tumor excision. These patients indeed had a two-stage insertion. 26 patients underwent one-stage surgery (group I) while 29 patients had a two-stage (group II) BAHA insertion. A period of 4 months was allowed for osseointegration before BAHA processor fitting. As for the safety assessment of the one-stage surgery, we compared both groups regarding the incidence and severity (minor, moderate and major) of encountered complications, as well as the operating time and follow-up. The operating time of the two-stage surgery includes the time of the first and of the second stage. The mean age at surgery was 8.5 years old for the group I and 50 years old for the group II patients. There was no difference in the incidence of minor (p=0.12), moderate (p=0.41) nor severe (p=0.68) complications between groups I and II. Two cases of traumatic extrusion were noted in the group I. Furthermore, the one-stage BAHA implantation requests a significantly lower operating time (mean: 54 [32-100] min) than the two-stage surgery (mean: 79 [63-148] min) (p=0.012). All pediatric cases of BAHA insertion were performed in a one day surgery. The mean postoperative follow-up was 114 and 96 weeks for groups I and II respectively (p=0.058). One-stage BAHA insertion surgery in the pediatric population is a reliable, safe and efficient therapeutic option that

Lernpunkt Deutsch--Stage 1.

ERIC Educational Resources Information Center

Theil, Elvira

1997-01-01

Evaluates the first stage of "Lernpunkt Deutsch," a new three-stage German course designed for upper elementary and early secondary school. Describes the publisher's package of materials and the appropriateness of the course, utility of the different package elements, format of the materials, and assesses whether the course provides pedagogically…

Weld Residual Stress and Distortion Analysis of the ARES I-X Upper Stage Simulator (USS)

NASA Technical Reports Server (NTRS)

Raju, Ivatury; Dawicke, David; Cheston, Derrick; Phillips, Dawn

2008-01-01

An independent assessment was conducted to determine the critical initial flaw size (CIFS) for the flange-to-skin weld in the Ares I-X Upper Stage Simulator (USS). The Ares system of space launch vehicles is the US National Aeronautics and Space Administration s plan for replacement of the aging space shuttle. The new Ares space launch system is somewhat of a combination of the space shuttle system and the Saturn launch vehicles used prior to the shuttle. Here, a series of weld analyses are performed to determine the residual stresses in a critical region of the USS. Weld residual stresses both increase constraint and mean stress thereby having an important effect on fatigue and fracture life. While the main focus of this paper is a discussion of the weld modeling procedures and results for the USS, a short summary of the CIFS assessment is provided.

Vaccine Therapy and Cyclophosphamide in Treating Patients With Stage II-III Breast or Stage II-IV Ovarian, Primary Peritoneal, or Fallopian Tube Cancer

ClinicalTrials.gov

2017-08-28

Recurrent Breast Carcinoma; Recurrent Fallopian Tube Carcinoma; Recurrent Ovarian Carcinoma; Recurrent Primary Peritoneal Carcinoma; Stage IIA Breast Cancer; Stage IIA Fallopian Tube Cancer; Stage IIA Ovarian Cancer; Stage IIB Breast Cancer; Stage IIB Fallopian Tube Cancer; Stage IIB Ovarian Cancer; Stage IIC Fallopian Tube Cancer; Stage IIC Ovarian Cancer; Stage IIIA Breast Cancer; Stage IIIA Fallopian Tube Cancer; Stage IIIA Ovarian Cancer; Stage IIIA Primary Peritoneal Cancer; Stage IIIB Breast Cancer; Stage IIIB Fallopian Tube Cancer; Stage IIIB Ovarian Cancer; Stage IIIB Primary Peritoneal Cancer; Stage IIIC Breast Cancer; Stage IIIC Fallopian Tube Cancer; Stage IIIC Ovarian Cancer; Stage IIIC Primary Peritoneal Cancer; Stage IV Fallopian Tube Cancer; Stage IV Ovarian Cancer; Stage IV Primary Peritoneal Cancer

Flight Results of the Chandra X-ray Observatory Inertial Upper Stage Space Mission

NASA Technical Reports Server (NTRS)

Tillotson, R.; Walter, R.

2000-01-01

Under contract to NASA, a specially configured version of the Boeing developed Inertial Upper Stage (IUS) booster was provided by Boeing to deliver NASA's 1.5 billion dollar Chandra X-Ray Observatory satellite into a highly elliptical transfer orbit from a Shuttle provided circular park orbit. Subsequently, the final orbit of the Chandra satellite was to be achieved using the Chandra Integral Propulsion System (IPS) through a series of IPS burns. On 23 July 1999 the Shuttle Columbia (STS-93) was launched with the IUS/Chandra stack in the Shuttle payload bay. Unfortunately, the Shuttle Orbiter was unexpectantly inserted into an off-nominal park orbit due to a Shuttle propulsion anomaly occurring during ascent. Following the IUS/Chandra on-orbit deployment from the Shuttle, at seven hours from liftoff, the flight proven IUS GN&C system successfully injected Chandra into the targeted transfer orbit, in spite of the off-nominal park orbit. This paper describes the IUS GN&C system, discusses the specific IUS GN&C mission data load development, analyses and testing for the Chandra mission, and concludes with a summary of flight results for the IUS part of the Chandra mission.

Staged cascade fluidized bed combustor

DOEpatents

Cannon, Joseph N.; De Lucia, David E.; Jackson, William M.; Porter, James H.

1984-01-01

A fluid bed combustor comprising a plurality of fluidized bed stages interconnected by downcomers providing controlled solids transfer from stage to stage. Each stage is formed from a number of heat transfer tubes carried by a multiapertured web which passes fluidizing air to upper stages. The combustor cross section is tapered inwardly from the middle towards the top and bottom ends. Sorbent materials, as well as non-volatile solid fuels, are added to the top stages of the combustor, and volatile solid fuels are added at an intermediate stage.

Solar Thermal Upper Stage Cryogen System Engineering Checkout Test

NASA Technical Reports Server (NTRS)

Olsen, A. D; Cady, E. C.; Jenkins, D. S.

1999-01-01

The Solar Thermal Upper Stage technology (STUSTD) program is a solar thermal propulsion technology program cooperatively sponsored by a Boeing led team and by NASA MSFC. A key element of its technology program is development of a liquid hydrogen (LH2) storage and supply system which employs multi-layer insulation, liquid acquisition devices, active and passive thermodynamic vent systems, and variable 40W tank heaters to reliably provide near constant pressure H2 to a solar thermal engine in the low-gravity of space operation. The LH2 storage and supply system is designed to operate as a passive, pressure fed supply system at a constant pressure of about 45 psia. During operation of the solar thermal engine over a small portion of the orbit the LH2 storage and supply system propulsively vents through the enjoy at a controlled flowrate. During the long coast portion of the orbit, the LH2 tank is locked up (unvented). Thus, all of the vented H2 flow is used in the engine for thrust and none is wastefully vented overboard. The key to managing the tank pressure and therefore the H2 flow to the engine is to manage and balance the energy flow into the LH2 tank with the MLI and tank heaters with the energy flow out of the LH2 tank through the vented H2 flow. A moderate scale (71 cu ft) LH2 storage and supply system was installed and insulated at the NASA MSFC Test Area 300. The operation of the system is described in this paper. The test program for the LH2 system consisted of two parts: 1) a series of engineering tests to characterize the performance of the various components in the system: and 2) a 30-day simulation of a complete LEO and GEO transfer mission. This paper describes the results of the engineering tests, and correlates these results with analytical models used to design future advanced Solar Orbit Transfer Vehicles.

Sildenafil exposure and hemodynamic effect after stage II single-ventricle surgery

PubMed Central

Hill, Kevin D.; Tunks, Robert D.; Barker, Piers C. A.; Benjamin, Daniel K.; Cohen-Wolkowiez, Michael; Fleming, Gregory A.; Laughon, Matthew; Li, Jennifer S.

2013-01-01

Objective To determine sildenafil exposure and hemodynamic effect in children after stage II single-ventricle surgery. Design Prospective, dose escalation trial. Setting Single-center, pediatric catheterization laboratory. Patients 12 children post stage II single-ventricle surgical palliation and undergoing elective cardiac catheterization: median age 1.9 years (range: 0.8, 4.0), weight 11 kg (8, 13), 9 females, and 10 with a single right ventricle. Interventions Catheterization and echocardiography performed before and immediately after single-dose intravenous sildenafil (0.125, 0.25, 0.35, or 0.45 mg/kg over 20 minutes). Measurements Peak sildenafil and des-methyl sildenafil concentration, change in hemodynamic parameters measured by cardiac catheterization and echocardiography including indexed pulmonary vascular resistance, and myocardial performance. Main Results Maximum sildenafil concentrations ranged from 92–775 ng/ml and were above the in vitro threshold needed for 77% phosphodiesterase type-5 (PDE-5) inhibition in 80% of subjects and 90% inhibition in 80% of subjects with doses ≥0.35 mg/kg. Sildenafil lowered pulmonary vascular resistance index (PVRI) in all 12 subjects (median PVRI 2.2 [range: 1.6, 7.9]; decreased to 1.7 [1.2, 5.4] WU x m2; p<0.01) with no dose-response effect. Sildenafil improved pulmonary blood flow (+8% [0, 20], p=0.04) and saturations (+2% [0, 16], p=0.04) in those with baseline PVRI ≥2 WU x m2 (n=7). Change in saturations correlated inversely with change in PVRI (r2 = 0.74 p<0.01). Sildenafil also lowered mean blood pressure (−12% [−20, +10]; p=0.04). There was no change in cardiac index and no effect on myocardial performance. There were no adverse events. Conclusions Sildenafil demonstrated non-linear exposure with high inter-individual variability but was well tolerated and effectively lowered PVRI in all subjects. Sildenafil did not acutely improve myocardial performance or increase cardiac index. PMID:23823195

Forensic age estimation based on magnetic resonance imaging of third molars: converting 2D staging into 3D staging.

PubMed

De Tobel, Jannick; Hillewig, Elke; Verstraete, Koenraad

2017-03-01

Established methods to stage development of third molars for forensic age estimation are based on the evaluation of radiographs, which show a 2D projection. It has not been investigated whether these methods require any adjustments in order to apply them to stage third molars on magnetic resonance imaging (MRI), which shows 3D information. To prospectively study root stage assessment of third molars in age estimation using 3 Tesla MRI and to compare this with panoramic radiographs, in order to provide considerations for converting 2D staging into 3D staging and to determine the decisive root. All third molars were evaluated in 52 healthy participants aged 14-26 years using MRI in three planes. Three staging methods were investigated by two observers. In sixteen of the participants, MRI findings were compared with findings on panoramic radiographs. Decisive roots were palatal in upper third molars and distal in lower third molars. Fifty-seven per cent of upper third molars were not assessable on the radiograph, while 96.9% were on MRI. Upper third molars were more difficult to evaluate on radiographs than on MRI (p < .001). Lower third molars were equally assessable on both imaging techniques (93.8% MRI, 98.4% radiograph), with no difference in level of difficulty (p = .375). Inter- and intra-observer agreement for evaluation was higher in MRI than in radiographs. In both imaging techniques lower third molars showed greater inter- and intra-observer agreement compared to upper third molars. MR images in the sagittal plane proved to be essential for staging. In age estimation, 3T MRI of third molars could be valuable. Some considerations are, however, necessary to transfer known staging methods to this 3D technique.

Role of Surgery in Stages II and III Pediatric Abdominal Non-Hodgkin Lymphoma: A 5-Years Experience

PubMed Central

Ali, Amany M.; Sayd, Heba A.; Hamza, Hesham M.; Salem, Mohamed A.

2011-01-01

Abdominal Non-Hodgkin lymphomas (NHL) are the most common extra nodal presentation of pediatric NHL. Our aim is to assess the role of surgery as a risk factor and to evaluate the impact of risk-adjusted systemic chemotherapy on survival of patients with stages II and III disease. This study included 35 pediatric patients with abdominal NHL treated over five years at South Egypt Cancer Institute (SECI), Assiut University, between January 2005 and January 2010. The data of every patient included: Age, sex, and presentation, staging work up to determine extent of the disease and the type of resection performed, histopathological examination, details of chemotherapy, disease free survival and overall survival. The study included 25 boys and 10 girls with a median age of six years (range: 2.5:15). Thirty patients (86%) presented with abdominal pain, 23 patients (66%) presented with abdominal mass and distention, 13 patients (34%) presented with weight loss, and intestinal obstruction occurred in six patients (17%). The ileo-cecal region and abdominal lymph nodes were the commonest sites (48.5%, 21% respectively). Burkitt's lymphoma was the most common histological type in 29 patients (83%). Ten (28.5%) stage II (group A) and 25 (71.5%) stage III (group B). Complete resections were performed in 10 (28.5%), debulking in 6 (17%) and imaging guided biopsy in 19 (54%). A11 patients received systemic chemotherapy. The median follow up duration was 63 months (range 51-78 months). The parameters that significantly affect the overall survival were stage at presentation complete resection for localized disease. In conclusion, the extent of disease at presentation is the most important prognostic factor in pediatric abdominal NHL. Surgery is restricted to defined situations such as; abdominal emergencies, diagnostic biopsy and total tumor extirpation in localized disease. Chemotherapy is the cornerstone in the management of pediatric abdominal NHL. PMID:24212775

Role of Surgery in Stages II and III Pediatric Abdominal Non-Hodgkin Lymphoma: A 5-Years Experience.

PubMed

Ali, Amany M; Sayd, Heba A; Hamza, Hesham M; Salem, Mohamed A

2011-03-29

Abdominal Non-Hodgkin lymphomas (NHL) are the most common extra nodal presentation of pediatric NHL. Our aim is to assess the role of surgery as a risk factor and to evaluate the impact of risk-adjusted systemic chemotherapy on survival of patients with stages II and III disease. This study included 35 pediatric patients with abdominal NHL treated over five years at South Egypt Cancer Institute (SECI), Assiut University, between January 2005 and January 2010. The data of every patient included: Age, sex, and presentation, staging work up to determine extent of the disease and the type of resection performed, histopathological examination, details of chemotherapy, disease free survival and overall survival. The study included 25 boys and 10 girls with a median age of six years (range: 2.5:15). Thirty patients (86%) presented with abdominal pain, 23 patients (66%) presented with abdominal mass and distention, 13 patients (34%) presented with weight loss, and intestinal obstruction occurred in six patients (17%). The ileo-cecal region and abdominal lymph nodes were the commonest sites (48.5%, 21% respectively). Burkitt's lymphoma was the most common histological type in 29 patients (83%). Ten (28.5%) stage II (group A) and 25 (71.5%) stage III (group B). Complete resections were performed in 10 (28.5%), debulking in 6 (17%) and imaging guided biopsy in 19 (54%). A11 patients received systemic chemotherapy. The median follow up duration was 63 months (range 51-78 months). The parameters that significantly affect the overall survival were stage at presentation complete resection for localized disease. In conclusion, the extent of disease at presentation is the most important prognostic factor in pediatric abdominal NHL. Surgery is restricted to defined situations such as; abdominal emergencies, diagnostic biopsy and total tumor extirpation in localized disease. Chemotherapy is the cornerstone in the management of pediatric abdominal NHL.

51. View of upper radar scanner switch in radar scanner ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

51. View of upper radar scanner switch in radar scanner building 105 from upper catwalk level showing emanating waveguides from upper switch (upper one-fourth of photograph) and emanating waveguides from lower radar scanner switch in vertical runs. - Clear Air Force Station, Ballistic Missile Early Warning System Site II, One mile west of mile marker 293.5 on Parks Highway, 5 miles southwest of Anderson, Anderson, Denali Borough, AK

Seismic stratigraphy of the Mississippi-Alabama shelf and upper continental slope

USGS Publications Warehouse

Kindinger, J.L.

1988-01-01

The Mississippi-Alabama shelf and upper continental slope contain relatively thin Upper Pleistocene and Holocene deposits. Five stages of shelf evolution can be identified from the early Wisconsinan to present. The stages were controlled by glacioeustatic or relative sea-level changes and are defined by the stratigraphic position of depositional and erosional episodes. The stratigraphy was identified on seismic profiles by means of geomorphic pattern, high-angle clinoform progradational deposits, buried stream entrenchments, planar conformities, and erosional unconformities. The oldest stage (stage 1) of evolution occurred during the early Wisconsinan lowstand; the subaerially exposed shelf was eroded to a smooth seaward-sloping surface. This paleosurface is overlain by a thin (< 10 m) drape of transgressive deposits (stage 2). Stage 3 occurred in three phases as the late Wisconsinan sea retreated: (1) fluvial channel systems eroded across the shelf, (2) deposited a thick (90 m) shelf-margin delta, and (3) contemporaneously deposited sediments on the upper slope. Stage 4 included the rapid Holocene sea-level rise that deposited a relatively thin transgressive facies over parts of the shelf. The last major depositional episode (stage 5) was the progradation of the St. Bernard delta over the northwestern and central parts of the area. A depositional hiatus has occurred since the St. Bernard progradation. These Upper Quaternary shelf and slope deposits provide models for analogous deposits in the geologic record. Primarily, they are examples of cyclic sedimentation caused by changes in sea level and may be useful in describing short-term, sandy depositional episodes in prograding shelf and slope sequences. ?? 1988.

Specific activity of cyclin-dependent kinase I is a new potential predictor of tumour recurrence in stage II colon cancer.

PubMed

Zeestraten, E C M; Maak, M; Shibayama, M; Schuster, T; Nitsche, U; Matsushima, T; Nakayama, S; Gohda, K; Friess, H; van de Velde, C J H; Ishihara, H; Rosenberg, R; Kuppen, P J K; Janssen, K-P

2012-01-03

There are no established biomarkers to identify tumour recurrence in stage II colon cancer. As shown previously, the enzymatic activity of the cyclin-dependent kinases 1 and 2 (CDK1 and CDK2) predicts outcome in breast cancer. Therefore, we investigated whether CDK activity identifies tumour recurrence in colon cancer. In all, 254 patients with completely resected (R0) UICC stage II colon cancer were analysed retrospectively from two independent cohorts from Munich (Germany) and Leiden (Netherlands). None of the patients received adjuvant treatment. Development of distant metastasis was observed in 27 patients (median follow-up: 86 months). Protein expression and activity of CDKs were measured on fresh-frozen tumour samples. Specific activity (SA) of CDK1 (CDK1SA), but not CDK2, significantly predicted distant metastasis (concordance index=0.69, 95% confidence interval (CI): 0.55-0.79, P=0.036). Cutoff derivation by maximum log-rank statistics yielded a threshold of CDK1SA at 11 (SA units, P=0.029). Accordingly, 59% of patients were classified as high-risk (CDK1SA ≥11). Cox proportional hazard analysis revealed CDK1SA as independent prognostic variable (hazard ratio=6.2, 95% CI: 1.44-26.9, P=0.012). Moreover, CKD1SA was significantly elevated in microsatellite-stable tumours. Specific activity of CDK1 is a promising biomarker for metastasis risk in stage II colon cancer.

Long-Term Survival and Local Relapse Following Surgery Without Radiotherapy for Locally Advanced Upper Rectal Cancer

PubMed Central

Park, Jun Seok; Sakai, Yoshiharu; Simon, NG Siu Man; Law, Wai Lun; Kim, Hyeong Rok; Oh, Jae Hwan; Shan, Hester Cheung Yui; Kwak, Sang Gyu; Choi, Gyu-Seog

2016-01-01

Abstract Controversy remains regarding whether preoperative chemoradiation protocol should be applied uniformly to all rectal cancer patients regardless of tumor height. This pooled analysis was designed to evaluate whether preoperative chemoradiation can be safely omitted in higher rectal cancer. An international consortium of 7 institutions was established. A review of the database that was collected from January 2004 to May 2008 identified a series of 2102 patients with stage II/III rectal or sigmoid cancer (control arm) without concurrent chemoradiation. Data regarding patient demographics, recurrence pattern, and oncological outcomes were analyzed. The primary end point was the 5-year local recurrence rate. The local relapse rate of the sigmoid colon cancer (SC) and upper rectal cancer (UR) cohorts was significantly lower than that of the mid/low rectal cancer group (M-LR), with 5-year estimates of 2.5% for the SC group, 3.5% for the UR group, and 11.1% for the M-LR group, respectively. A multivariate analysis showed that tumor depth, nodal metastasis, venous invasion, and lower tumor level were strongly associated with local recurrence. The cumulative incidence rate of local failure was 90.6%, 92.5%, and 94.4% for tumors located within 5, 7, and 9 cm from the anal verge, respectively. Routine use of preoperative chemoradiation for stage II/III rectal tumors located more than 8 to 9 cm above the anal verge would be excessive. The integration of a more individualized approach focused on systemic control is warranted to improve survival in patients with upper rectal cancer. PMID:27258487

Feasibility of sequential adjuvant chemotherapy with a 3-month oxaliplatin-based regimen followed by 3 months of capecitabine in patients with stage III and high-risk stage II colorectal cancer: JSWOG-C2 study.

PubMed

Tsuruta, Atsushi; Yamashita, Kazuki; Tanioka, Hiroaki; Tsuji, Akihito; Inukai, Michio; Yamakawa, Toshiki; Yamatsuji, Tomoki; Yoshimitsu, Masanori; Toyota, Kazuhiro; Yamano, Taketoshi; Nagasaka, Takeshi; Okajima, Masazumi

2016-01-01

Six months of oxaliplatin-based chemotherapy is the standard adjuvant chemotherapy for completely resected stage III colorectal cancer (CRC). Also, patients with stage II CRC who are considered to be at high risk of disease recurrence often receive the same adjuvant chemotherapy treatment. We prospectively investigated the extent and degree of neuropathy suffered by stage III and high-risk stage II resectable CRC patients who underwent sequential approach involving 3 months of an oxaliplatin-based regimen followed by 3 months of capecitabine. Patients with completely resected stage III and high-risk stage II CRC aged ≥20 years were eligible. Patients were treated with folinic acid, fluorouracil, and oxaliplatin (FOLFOX) or capecitabine and oxaliplatin (CAPOX) for 3 months followed by capecitabine (2,500 mg/m 2 on days 1-14 every 3 weeks) for 3 months. Primary end points were frequency and the grade of oxaliplatin-induced neurotoxicity as evaluated using the physician-based Common Terminology Criteria for Adverse Events version 4.0 (CTCAE) grading and the patient-based scale, self-reported Patient Neurotoxicity Questionnaire. Ninety-one patients were enrolled and 86 patients assessed. Eighty-four percent of patients completed the planned oxaliplatin-based therapy for 3 months, and 63% of patients completed all treatments for the full 6 months. Overall incidences of grade 3 or 4 peripheral sensory or motor neuropathy according to the CTCAE were 3.5% and 1.2%, respectively. Regarding the peripheral sensory neuropathy, the proportion of Patient Neurotoxicity Questionnaire (grade C-E) and CTCAE (grade 2-4) at months 1.5/3/6 were 11.3/22.1/29.4% and 5.3/4.4/11.3%, respectively (Spearman correlation coefficient: 0.47). A sequential approach to adjuvant chemotherapy with 3 months of an oxaliplatin-based regimen followed by 3 months of capecitabine was tolerated by patients and associated with a low incidence of neuropathy.

Early stages of the recovery stroke in myosin II studied by molecular dynamics simulations

PubMed Central

Baumketner, Andrij; Nesmelov, Yuri

2011-01-01

The recovery stroke is a key step in the functional cycle of muscle motor protein myosin, during which pre-recovery conformation of the protein is changed into the active post-recovery conformation, ready to exersice force. We study the microscopic details of this transition using molecular dynamics simulations of atomistic models in implicit and explicit solvent. In more than 2 μs of aggregate simulation time, we uncover evidence that the recovery stroke is a two-step process consisting of two stages separated by a time delay. In our simulations, we directly observe the first stage at which switch II loop closes in the presence of adenosine triphosphate at the nucleotide binding site. The resulting configuration of the nucleotide binding site is identical to that detected experimentally. Distribution of inter-residue distances measured in the force generating region of myosin is in good agreement with the experimental data. The second stage of the recovery stroke structural transition, rotation of the converter domain, was not observed in our simulations. Apparently it occurs on a longer time scale. We suggest that the two parts of the recovery stroke need to be studied using separate computational models. PMID:21922589

Staging of Lung Cancer

MedlinePlus

... LUNG CANCER MINI-SERIES #2 Staging of Lung Cancer Once your lung cancer is diagnosed, staging tells you and your health care provider about ... at it under a microscope. The stages of lung cancer are listed as I, II, III, and IV ...

Broad-spectrum Antibiotic Plus Metronidazole May Not Prevent the Deterioration of Necrotizing Enterocolitis From Stage II to III in Full-term and Near-term Infants

PubMed Central

Luo, Li-Juan; Li, Xin; Yang, Kai-Di; Lu, Jiang-Yi; Li, Lu-Quan

2015-01-01

Abstract Necrotizing enterocolitis (NEC) is the most common and frequently dangerous neonatal gastrointestinal disease. Studies have shown broad-spectrum antibiotics plus anaerobic antimicrobial therapy did not prevent the deterioration of NEC among very low birth preterm infants. However, few studies about this therapy which focused on full-term and near-term infant with NEC has been reported. The aim of this study was to evaluate the effect of broad-spectrum antibiotic plus metronidazole in preventing the deterioration of NEC from stage II to III in full-term and near-term infants. A retrospective cohort study based on the propensity score (PS) 1:1 matching was performed among the full-term and near-term infants with NEC (Bell stage ≥II). All infants who received broad-spectrum antibiotics were divided into 2 groups: group with metronidazole treatment (metronidazole was used ≥4 days continuously, 15 mg/kg/day) and group without metronidazole treatment. The depraved rates of stage II NEC between the 2 groups were compared. Meanwhile, the risk factors associated with the deterioration of stage II NEC were analyzed by case-control study in the PS-matched cases. A total of 229 infants met the inclusion criteria. Before PS-matching, we found the deterioration of NEC rate in the group with metronidazole treatment was higher than that in the group without metronidazole treatment (18.1% [28/155] vs 8.1% [6/74]; P = 0.048). After PS-matching, 73 pairs were matched, and the depraved rate of NEC in the group with metronidazole treatment was not lower than that in the group without metronidazole treatment (15.1% vs 8.2%; P = 0.2). Binary logistic regression analysis showed that sepsis after NEC (odds ratio [OR] 3.748, 95% confidence interval [CI] 1.171–11.998, P = 0.03), the need to use transfusion of blood products after diagnosis of NEC (OR 8.003, 95% CI 2.365–27.087, P = 0.00), and the need of longer time for nasogastric suction were risk factors

Prognostic implications of occult nodal tumour cells in stage I and II colon cancer: The correlation between micrometastasis and disease recurrence.

PubMed

Sloothaak, D A M; van der Linden, R L A; van de Velde, C J H; Bemelman, W A; Lips, D J; van der Linden, J C; Doornewaard, H; Tanis, P J; Bosscha, K; van der Zaag, E S; Buskens, C J

2017-08-01

Occult nodal tumour cells should be categorised as micrometastasis (MMs) and isolated tumour cells (ITCs). A recent meta-analysis demonstrated that MMs, but not ITCs, are prognostic for disease recurrence in patients with stage I/II colon cancer. The objective of this retrospective multicenter study was to correlate MMs and ITCs to characteristics of the primary tumour, and to determine their prognostic value in patients with stage I/II colon cancer. One hundred ninety two patients were included in the study with a median follow up of 46 month (IQR 33-81 months). MMs were found in eight patients (4.2%), ITCs in 37 (19.3%) and occult tumour cells were absent in 147 patients (76.6%). Between these groups, tumour differentiation and venous or lymphatic invasion was equally distributed. Advanced stage (pT3/pT4) was found in 66.0% of patients without occult tumour cells (97/147), 72.9% of patients with ITCs (27/37), and 100% in patients with MMs (8/8), although this was a non-significant trend. Patients with MMs showed a significantly reduced 3 year-disease free survival compared to patients with ITCs or patients without occult tumour cells (75.0% versus 88.0% and 94.8%, respectively, p = 0.005). When adjusted for T-stage, MMs independently predicted recurrence of cancer (OR 7.6 95% CI 1.5-37.4, p = 0.012). In this study, the incidence of MMs and ITCs in patients with stage I/II colon cancer was 4.2% and 19.3%, respectively. MMs were associated with an reduced 3 year disease free survival rate, but ITCs were not. Copyright © 2017 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

Computer program for prediction of fuel consumption statistical data for an upper stage three-axes stabilized on-off control system

NASA Technical Reports Server (NTRS)

1982-01-01

A FORTRAN coded computer program and method to predict the reaction control fuel consumption statistics for a three axis stabilized rocket vehicle upper stage is described. A Monte Carlo approach is used which is more efficient by using closed form estimates of impulses. The effects of rocket motor thrust misalignment, static unbalance, aerodynamic disturbances, and deviations in trajectory, mass properties and control system characteristics are included. This routine can be applied to many types of on-off reaction controlled vehicles. The pseudorandom number generation and statistical analyses subroutines including the output histograms can be used for other Monte Carlo analyses problems.

Unraveling hominin behavior at another anthropogenic site from Olduvai Gorge (Tanzania): new archaeological and taphonomic research at BK, Upper Bed II.

PubMed

Domínguez-Rodrigo, M; Mabulla, A; Bunn, H T; Barba, R; Diez-Martín, F; Egeland, C P; Espílez, E; Egeland, A; Yravedra, J; Sánchez, P

2009-09-01

New archaeological excavations and research at BK, Upper Bed II (Olduvai Gorge, Tanzania) have yielded a rich and unbiased collection of fossil bones. These new excavations show that BK is a stratified deposit formed in a riverine setting close to an alluvial plain. The present taphonomic study reveals the second-largest collection of hominin-modified bones from Olduvai, with abundant cut marks found on most of the anatomical areas preserved. Meat and marrow exploitation is reconstructed using the taphonomic signatures left on the bones by hominins. Highly cut-marked long limb shafts, especially those of upper limb bones, suggest that hominins at BK were actively engaged in acquiring small and middle-sized animals using strategies other than passive scavenging. The exploitation of large-sized game (Pelorovis) by Lower Pleistocene hominins, as suggested by previous researchers, is supported by the present study.

Randomized Controlled Trial Comparing Orthosis Augmented by Either Stretching or Stretching and Strengthening for Stage II Tibialis Posterior Tendon Dysfunction.

PubMed

Houck, Jeff; Neville, Christopher; Tome, Josh; Flemister, Adolph

2015-09-01

The value of strengthening and stretching exercises combined with orthosis treatment in a home-based program has not been evaluated. The purpose of this study was to compare the effects of augmenting orthosis treatment with either stretching or a combination of stretching and strengthening in participants with stage II tibialis posterior tendon dysfunction (TPTD). Participants included 39 patients with stage II TPTD who were recruited from a medical center and then randomly assigned to a strengthening or stretching treatment group. Excluding 3 dropouts, there were 19 participants in the strengthening group and 17 in the stretching group. The stretching treatment consisted of a prefabricated orthosis used in conjunction with stretching exercises. The strengthening treatment consisted of a prefabricated orthosis used in conjunction with the stretching and strengthening exercises. The main outcome measures were self-report (ie, Foot Function Index and Short Musculoskeletal Function Assessment) and isometric deep posterior compartment strength. Two-way analysis of variance was used to test for differences between groups at 6 and 12 weeks after starting the exercise programs. Both groups significantly improved in pain and function over the 12-week trial period. The self-report measures showed minimal differences between the treatment groups. There were no differences in isometric deep posterior compartment strength. A moderate-intensity, home-based exercise program was minimally effective in augmenting orthosis wear alone in participants with stage II TPTD. Level I, prospective randomized study. © The Author(s) 2015.

Social Development Training Project. Stage I and Stage II. [The Granville Project].

ERIC Educational Resources Information Center

Riches, Vivienne C., Ed.

The book presents a training program developed at the Granville Work Preparation Centre in Australia, to teach mildly retarded adolescents basic social skills and competencies. The program is divided into two stages, with a total of 17 different skill areas. Stage 1 covers self-awareness, social/interpersonal skills, relaxation and behavioral self…

Concurrent chemoradiotherapy degrades the quality of life of patients with stage II nasopharyngeal carcinoma as compared to radiotherapy

PubMed Central

Pan, Xin-Bin; Huang, Shi-Ting; Chen, Kai-Hua; Jiang, Yan-Ming; Ma, Jia-Lin; Qu, Song; Li, Ling; Chen, Long; Zhu, Xiao-Dong

2017-01-01

The purpose of this study was to compare the quality of life (QoL) of stage II nasopharyngeal carcinoma (NPC) patients treated with radiotherapy (RT) versus concurrent chemoradiotherapy (CCRT). In a cross-sectional study, these patients were treated with RT (n = 55) or CCRT (n = 51) between June 2008 and June 2013. For all subjects, disease-free survival was more than 3 years. QoL was assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) questions and the Head and Neck 35 (EORTC QLQ-H&N35) questions. RT had better outcomes than CCRT for global QoL, functional scales, symptom scales of fatigue and insomnia, financial problems, and weight gain. Survivors receiving 1 cycle of concurrent chemotherapy had worse QoL outcomes than survivors receiving 2 cycles of concurrent chemotherapy. Patients receiving 3 cycles of concurrent chemotherapy had the best QoL outcomes. Thus, CCRT adversely affects the QoL of patients with stage II NPC as compared to radiotherapy. PMID:28152511

Upper-Tropospheric Synoptic-Scale Waves. Part II: Maintenance and Excitation of Quasi Modes.

NASA Astrophysics Data System (ADS)

Rivest, Chantal; Farrell, Brian F.

1992-11-01

In a preceding paper a simple dynamical model for the maintenance of upper-tropospheric waves was proposed: the upper-level Eady normal modes. In this paper it is shown that these modes have counterparts in basic states with positive tropospheric gradients of potential vorticity, and that these counterparts can be maintained and excited on time scales consistent with observations.In the presence of infinitesimal positive tropospheric gradients of potential vorticity, the upper-level normal-mode solutions no longer exist. That the normal-mode solution disappears when gradients are infinitesimal represents an apparent singularity and challenges the interpretation of upper-level synoptic-scale waves as related to the upper-level Eady normal modes. What happens to the upper-level modal solution in the presence of tropospheric gradients of potential vorticity is examined in a series of initial-value experiments. Our results show that they become slowly decaying quasi modes. Mathematically the quasi modes consist of a superposition of singular modes sharply peaked in the phase speed domain, and their decay proceeds as the modes interfere with one another. We repeat these experiments in basic states with a smooth tropopause in the presence of tropospheric and stratospheric gradients, and similar results are obtained.Following a previous study by Farrell, a class of near-optimal initial conditions for the excitation of upper-level waves is identified. The initial conditions consist of upper-tropospheric disturbances that lean against the shear. They strongly excite upper-level waves not only in the absence of tropospheric potential vorticity gradients, but also in their presence. This result is important mathematically since it suggests that quasi modes are as likely to emerge from favorably configured initial disturbances as true normal modes, although the excitation is followed by a slow decay.

Annual variations of water vapor in the stratosphere and upper troposphere observed by the Stratospheric Aerosol and Gas Experiment II

NASA Technical Reports Server (NTRS)

Mccormick, M. P.; Chiou, E. W.; Mcmaster, L. R.; Chu, W. P.; Larsen, J. C.; Rind, D.; Oltmans, S.

1993-01-01

Data collected by the Stratospheric Aerosol and Gas Experiment II are presented, showing annual variations of water vapor in the stratosphere and the upper troposphere. The altitude-time cross sections of water vapor were found to exhibit annually repeatable patterns in both hemispheres, with a yearly minimum in water vapor appearing in both hemispheres at about the same time, supporting the concept of a common source for stratospheric dry air. A linear regression analysis was applied to the three-year data set to elucidate global values and variations of water vapor ratio.

Adjuvant FOLFOX chemotherapy and splenomegaly in patients with stages II-III colorectal cancer.

PubMed

Angitapalli, Revathi; Litwin, Alan M; Kumar, Prasanna R G; Nasser, Eiad; Lombardo, Jeffrey; Mashtare, Terry; Wilding, Gregory E; Fakih, Marwan G

2009-01-01

The impact of adjuvant chemotherapy on hepatic function and portal hypertension in patients with stages II-III colon cancer has not been previously described. We conducted a retrospective study to assess the effects of adjuvant FOLFOX chemotherapy on the splenic index (SI) as a surrogate marker for portal hypertension. Stage II-III colorectal cancer patients treated with adjuvant FOLFOX or fluorouracil/leucovorin (5-FU/LV) at Roswell Park Cancer Institute between 2002 and 2006 were identified. Computerizedt omography (CT) scans obtained prior to and at completion of chemotherapy, and every 6 months thereafter were reviewed. Splenic size was evaluated using the SI (SI = length x width x height of the spleen). 40 patients were identified in the FOLFOX group and 23 in the 5-FU/LV group. After 6 months of adjuvant chemotherapy, the mean increase in SI was 45.7 and 16.3% in the FOLFOX and 5-FU/LV groups, respectively (p = 0.0069). SI increased by >100% in 6 patients (15%) in the FOLFOX group versus none in the 5-FU/LV group (p = 0.16). The mean SI at completion of adjuvant chemotherapy was significantly higher in the FOLFOX group than in the 5-FU/LV group (p = 0.007). The mean SI decreased steadily over a period of 2 years after discontinuation of FOLFOX, suggesting potential reversibility of oxaliplatin-induced hepatic injury in this setting. Adjuvant FOLFOX significantly increases the SI in patients with resected colorectal cancer in comparison to adjuvant 5-FU/LV. The increase in SI may be a marker of oxaliplatin-induced hepatic injury and should be investigated further in prospective longitudinal studies of oxaliplatin-based adjuvant chemotherapy. Copyright 2009 S. Karger AG, Basel.

Integrative marker analysis allows risk assessment for metastasis in stage II colon cancer.

PubMed

Nitsche, Ulrich; Rosenberg, Robert; Balmert, Alexander; Schuster, Tibor; Slotta-Huspenina, Julia; Herrmann, Pia; Bader, Franz G; Friess, Helmut; Schlag, Peter M; Stein, Ulrike; Janssen, Klaus-Peter

2012-11-01

Individualized risk assessment in patients with UICC stage II colon cancer based on a panel of molecular genetic alterations. Risk assessment in patients with colon cancer and localized disease (UICC stage II) is not sufficiently reliable. Development of metachronous metastasis is assumed to be governed largely by individual tumor genetics. Fresh frozen tissue from 232 patients (T3-4, N0, M0) with complete tumor resection and a median follow-up of 97 months was analyzed for microsatellite stability, KRAS exon 2, and BRAF exon 15 mutations. Gene expression of the WNT-pathway surrogate marker osteopontin and the metastasis-associated genes SASH1 and MACC1 was determined for 179 patients. The results were correlated with metachronous distant metastasis risk (n = 22 patients). Mutations of KRAS were detected in 30% patients, mutations of BRAF in 15% patients, and microsatellite instability in 26% patients. Risk of recurrence was associated with KRAS mutation (P = 0.033), microsatellite stable tumors (P = 0.015), decreased expression of SASH1 (P = 0.049), and increased expression of MACC1 (P < 0.001). MACC1 was the only independent parameter for recurrence prediction (hazard ratio: 6.2; 95% confidence interval: 2.4-16; P < 0.001). Integrative 2-step cluster analysis allocated patients into 4 groups, according to their tumor genetics. KRAS mutation, BRAF wild type, microsatellite stability, and high MACC1 expression defined the group with the highest risk of recurrence (16%, 7 of 43), whereas BRAF wild type, microsatellite instability, and low MACC1 expression defined the group with the lowest risk (4%, 1 of 26). MACC1 expression predicts development of metastases, outperforming microsatellite stability status, as well as KRAS/BRAF mutation status.

10-year changes in upper body strength and power in elite professional rugby league players--the effect of training age, stage, and content.

PubMed

Baker, Daniel G

2013-02-01

The purpose of this investigation was to observe changes in maximal upper body strength and power across a 10-year period in professional athletes who were experienced resistance trainers. Six professional rugby league players were observed with test data reported according to 2 important training stages in their professional careers. The first stage (1996-1998) monitored the changes as the subjects strived to establish themselves as elite professionals in their sport. The remaining test data are from the latter stage (2000-2006), which is characterized by a longer competition schedule and shorter periods devoted to improving physical preparation. The changes in upper body strength, assessed by the 1 repetition maximum bench press and mean maximum power during bench press throws with various barbell resistances of 40-80 kg, were assessed by effect size (ES) and smallest worthwhile change (SWC) statistics. Large increases in strength and power of approximately 22-23% were reported across the 10-year period, however, only small changes (as determined by ES) in strength or power occurred after year 2000 till 2006. This result of only small changes in strength or power despite 6 years of intense resistance training was attributed to 3 main factors. Key among them are the possible existence of a "strength ceiling" for experienced resistance trainers, the Long-term Athlete Development model, and possibly an inappropriate volume of strength-endurance training from 2004 to 2005. The fact that an SWC in strength and power occurred in the year after the cessation of strength-endurance training suggests that training program manipulation is still an influencing factor in continuing strength and power gains in experienced resistance trainers.

Outcomes and Effect of Radiotherapy in Patients With Stage I or II Diffuse Large B-Cell Lymphoma: A Surveillance, Epidemiology, and End Results Analysis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ballonoff, Ari; Rusthoven, Kyle E.; Schwer, Amanda

2008-12-01

Purpose: To assess disease-specific survival (DSS), overall survival (OS), and the effect of radiotherapy (RT) in patients with localized diffuse large B-cell lymphoma (DLBCL). Patients and Methods: The Surveillance, Epidemiology, and End Results database was queried for all patients diagnosed with Stage I, IE, II, or IIE DLBCL between 1988 and 2004. The analyzable data included gender, age, race, stage, presence of extranodal disease, and RT administration. Patients who had died or were lost to follow-up within 6 months of diagnosis were excluded. Results: A total of 13,420 patients met the search criteria. Of these, 5,547 (41%) had received RTmore » and 7,873 (59%) had not. RT was associated with a significant DSS (hazard ratio, 0.82, p <0.0001) and OS benefit that persisted during the 15 years of follow-up. Elderly patients, defined either as those >60 or >70 years old, had significantly improved DSS and OS associated with RT. On multivariate analysis, RT was significantly associated with increased DSS and OS. The 5-year DSS outcomes were highly variable among patient subsets, defined by age, stage, and extranodal disease (range for RT-treated patients, 70% for Stage II, age >60 years to 87% for Stage I, age {<=}60 years). Conclusion: This analysis presents the largest detailed data set of Stage I-II DLBCL patients. The results of our study have demonstrated that RT is associated with a survival advantage in patients with localized DLBCL, a benefit that extends to elderly patients. Outcomes for discrete patient subsets varied greatly. The development of tailored therapy according to the relapse risk is warranted, rather than uniform treatment of all early-stage DLBCL.« less

Changing the facial features of patients with Treacher Collins syndrome: protocol for 3-stage treatment of hard and soft tissue hypoplasia in the upper half of the face.

PubMed

Mitsukawa, Nobuyuki; Saiga, Atsuomi; Satoh, Kaneshige

2014-07-01

Treacher Collins syndrome is a disorder characterized by various congenital soft tissue anomalies involving hypoplasia of the zygoma, maxilla, and mandible. A variety of treatments have been reported to date. These treatments can be classified into 2 major types. The first type involves osteotomy for hard tissue such as the zygoma and mandible. The second type involves plastic surgery using bone grafting in the malar region and soft tissue repair of eyelid deformities. We devised a new treatment to comprehensively correct hard and soft tissue deformities in the upper half of the face of Treacher Collins patients. The aim was to "change facial features and make it difficult to tell that the patients have this disorder." This innovative treatment strategy consists of 3 stages: (1) placement of dermal fat graft from the lower eyelid to the malar subcutaneous area, (2) custom-made synthetic zygomatic bone grafting, and (3) Z-plasty flap transposition from the upper to the lower eyelid and superior repositioning and fixation of the lateral canthal tendon using a Mitek anchor system. This method was used on 4 patients with Treacher Collins syndrome who had moderate to severe hypoplasia of the zygomas and the lower eyelids. Facial features of these patients were markedly improved and very good results were obtained. There were no major complications intraoperatively or postoperatively in any of the patients during the series of treatments. In synthetic bone grafting in the second stage, the implant in some patients was in the way of the infraorbital nerve. Thus, the nerve was detached and then sutured under the microscope. Postoperatively, patients had almost full restoration of sensory nerve torpor within 5 to 6 months. We devised a 3-stage treatment to "change facial features" of patients with hypoplasia of the upper half of the face due to Treacher Collins syndrome. The treatment protocol provided a very effective way to treat deformities of the upper half of the face

Computer program for prediction of capture maneuver probability for an on-off reaction controlled upper stage

NASA Technical Reports Server (NTRS)

Knauber, R. N.

1982-01-01

A FORTRAN coded computer program which computes the capture transient of a launch vehicle upper stage at the ignition and/or separation event is presented. It is for a single degree-of-freedom on-off reaction jet attitude control system. The Monte Carlo method is used to determine the statistical value of key parameters at the outcome of the event. Aerodynamic and booster induced disturbances, vehicle and control system characteristics, and initial conditions are treated as random variables. By appropriate selection of input data pitch, yaw and roll axes can be analyzed. Transient response of a single deterministic case can be computed. The program is currently set up on a CDC CYBER 175 computer system but is compatible with ANSI FORTRAN computer language. This routine has been used over the past fifteen (15) years for the SCOUT Launch Vehicle and has been run on RECOMP III, IBM 7090, IBM 360/370, CDC6600 and CDC CYBER 175 computers with little modification.

Ares I-X Upper Stage Simulator Structural Analyses Supporting the NESC Critical Initial Flaw Size Assessment

NASA Technical Reports Server (NTRS)

Knight, Norman F., Jr.; Phillips, Dawn R.; Raju, Ivatury S.

2008-01-01

The structural analyses described in the present report were performed in support of the NASA Engineering and Safety Center (NESC) Critical Initial Flaw Size (CIFS) assessment for the ARES I-X Upper Stage Simulator (USS) common shell segment. The structural analysis effort for the NESC assessment had three thrusts: shell buckling analyses, detailed stress analyses of the single-bolt joint test; and stress analyses of two-segment 10 degree-wedge models for the peak axial tensile running load. Elasto-plastic, large-deformation simulations were performed. Stress analysis results indicated that the stress levels were well below the material yield stress for the bounding axial tensile design load. This report also summarizes the analyses and results from parametric studies on modeling the shell-to-gusset weld, flange-surface mismatch, bolt preload, and washer-bearing-surface modeling. These analyses models were used to generate the stress levels specified for the fatigue crack growth assessment using the design load with a factor of safety.

Feasibility of sequential adjuvant chemotherapy with a 3-month oxaliplatin-based regimen followed by 3 months of capecitabine in patients with stage III and high-risk stage II colorectal cancer: JSWOG-C2 study

PubMed Central

Tsuruta, Atsushi; Yamashita, Kazuki; Tanioka, Hiroaki; Tsuji, Akihito; Inukai, Michio; Yamakawa, Toshiki; Yamatsuji, Tomoki; Yoshimitsu, Masanori; Toyota, Kazuhiro; Yamano, Taketoshi; Nagasaka, Takeshi; Okajima, Masazumi

2016-01-01

Background Six months of oxaliplatin-based chemotherapy is the standard adjuvant chemotherapy for completely resected stage III colorectal cancer (CRC). Also, patients with stage II CRC who are considered to be at high risk of disease recurrence often receive the same adjuvant chemotherapy treatment. We prospectively investigated the extent and degree of neuropathy suffered by stage III and high-risk stage II resectable CRC patients who underwent sequential approach involving 3 months of an oxaliplatin-based regimen followed by 3 months of capecitabine. Patients and methods Patients with completely resected stage III and high-risk stage II CRC aged ≥20 years were eligible. Patients were treated with folinic acid, fluorouracil, and oxaliplatin (FOLFOX) or capecitabine and oxaliplatin (CAPOX) for 3 months followed by capecitabine (2,500 mg/m2 on days 1–14 every 3 weeks) for 3 months. Primary end points were frequency and the grade of oxaliplatin-induced neurotoxicity as evaluated using the physician-based Common Terminology Criteria for Adverse Events version 4.0 (CTCAE) grading and the patient-based scale, self-reported Patient Neurotoxicity Questionnaire. Results Ninety-one patients were enrolled and 86 patients assessed. Eighty-four percent of patients completed the planned oxaliplatin-based therapy for 3 months, and 63% of patients completed all treatments for the full 6 months. Overall incidences of grade 3 or 4 peripheral sensory or motor neuropathy according to the CTCAE were 3.5% and 1.2%, respectively. Regarding the peripheral sensory neuropathy, the proportion of Patient Neurotoxicity Questionnaire (grade C–E) and CTCAE (grade 2–4) at months 1.5/3/6 were 11.3/22.1/29.4% and 5.3/4.4/11.3%, respectively (Spearman correlation coefficient: 0.47). Conclusion A sequential approach to adjuvant chemotherapy with 3 months of an oxaliplatin-based regimen followed by 3 months of capecitabine was tolerated by patients and associated with a low incidence of

Squalene epoxidase, located on chromosome 8q24.1, is upregulated in 8q+ breast cancer and indicates poor clinical outcome in stage I and II disease.

PubMed

Helms, M W; Kemming, D; Pospisil, H; Vogt, U; Buerger, H; Korsching, E; Liedtke, C; Schlotter, C M; Wang, A; Chan, S Y; Brandt, B H

2008-09-02

Gains of chromosomes 7p and 8q are associated with poor prognosis among oestrogen receptor-positive (ER+) stage I/II breast cancer. To identify transcriptional changes associated with this breast cancer subtype, we applied suppression subtractive hybridisation method to analyse differentially expressed genes among six breast tumours with and without chromosomal 7p and 8q gains. Identified mRNAs were validated by real-time RT-PCR in tissue samples obtained from 186 patients with stage I/II breast cancer. Advanced statistical methods were applied to identify associations of mRNA expression with distant metastasis-free survival (DMFS). mRNA expression of the key enzyme of cholesterol biosynthesis, squalene epoxidase (SQLE, chromosomal location 8q24.1), was associated with ER+ 7p+/8q+ breast cancer. Distant metastasis-free survival in stage I/II breast cancer cases was significantly inversely related to SQLE mRNA in multivariate Cox analysis (P<0.001) in two independent patient cohorts of 160 patients each. The clinically favourable group associated with a low SQLE mRNA expression could be further divided by mRNA expression levels of the oestrogen-regulated zinc transporter LIV-1. The data strongly support that SQLE mRNA expression might indicate high-risk ER+ stage I/II breast cancers. Further studies on tumour tissue from standardised treated patients, for example with tamoxifen, may validate the role of SQLE as a novel diagnostic parameter for ER+ early stage breast cancers.

Coal workers pneumoconiosis - stage II (image)

MedlinePlus

... borders, representing coalescence (merging together) of previously distinct light areas. Diseases which may explain these x-ray findings include simple coal workers pneumoconiosis (CWP) - stage ...

Rocket stage - Trans-orbit booster Fregat

NASA Astrophysics Data System (ADS)

Asyushkin, V. A.; Papkov, O. V.

1993-10-01

This paper discusses a proposal for increasing the payload-carrying capability of a launch vehicle by using the Fregat booster stage (as the fourth stage for the R-7A launcher and as the fifth stage for the Proton launch vehicle). Particular attention is given to the tasks which the Fregat booster stage is designed to fulfill, the systems which are part of the Fregat, and the launch vehicles which will use Fregat as the upper stage. The main performance parameters of the Fregat stage are presented, as well as diagrams illustrating the performance of the Fregat booster stage.

Expression of PAT and NPT II proteins during the developmental stages of a genetically modified pepper developed in Korea.

PubMed

Kim, Hyo Jin; Lee, Si Myung; Kim, Jae Kwang; Ryu, Tae Hun; Suh, Seok Cheol; Cho, Hyun Suk

2010-10-27

Estimation of the protein levels introduced in a biotechnology-derived product is conducted as part of an overall safety assessment. An enzyme-linked immunosorbent assay (ELISA) was used to analyze phosphinothricin acetyltransferase (PAT) and neomycin phosphotransferase II (NPT II) protein expression in a genetically modified (GM) pepper plant developed in Korea. PAT and NPT II expression levels, based on both dry weight and fresh weight, were variable among different plant generations and plant sections from isolated genetically modified organism (GMO) fields at four developmental stages. PAT expression was highest in leaves at anthesis (11.44 μg/gdw and 2.17 μg/gfw) and lowest in roots (0.12 μg/gdw and 0.01 μg/gfw). NPT II expression was also highest in leaves at anthesis (17.31 μg/gdw and 3.41 μg/gfw) and lowest in red pepper (0.65 μg/gdw and 0.12 μg/gfw). In pollen, PAT expression was 0.59-0.62 μg/gdw, while NPT II was not detected. Both PAT and NPT II showed a general pattern of decreased expression with progression of the growing season. As expected, PAT and NPT II protein expression was not detectable in control pepper plants.

Development of an Interactive Shoreline Management Tool for the Lower Wood River Valley, Oregon - Phase I: Stage-Volume and Stage-Area Relations

USGS Publications Warehouse

Haluska, Tana L.; Snyder, Daniel T.

2007-01-01

This report presents the parcel and inundation area geographic information system (GIS) layers for various surface-water stages. It also presents data tables containing the water stage, inundation area, and water volume relations developed from analysis of detailed land surface elevation derived from Light Detection and Ranging (LiDAR) data recently collected for the Wood River Valley at the northern margin of Agency Lake in Klamath County, Oregon. Former shoreline wetlands that have been cut off from Upper Klamath and Agency Lakes by dikes might in the future be reconnected to Upper Klamath and Agency Lakes by breaching the dikes. Issues of interest associated with restoring wetlands in this way include the area that will be inundated, the volume of water that may be stored, the change in wetland habitat, and the variation in these characteristics as surface-water stage is changed. Products from this analysis can assist water managers in assessing the effect of breaching dikes and changing surface-water stage. The study area is in the approximate former northern margins of Upper Klamath and Agency Lakes in the Wood River Valley.

Tumors with unmethylated MLH1 and the CpG island methylator phenotype are associated with a poor prognosis in stage II colorectal cancer patients

PubMed Central

Fu, Tao; Liu, Yanliang; Li, Kai; Wan, Weiwei; Pappou, Emmanouil P.; Iacobuzio-Donahue, Christine A.; Kerner, Zachary; Baylin, Stephen B.; Wolfgang, Christopher L.; Ahuja, Nita

2016-01-01

We previously developed a novel tumor subtype classification model for duodenal adenocarcinomas based on a combination of the CpG island methylator phenotype (CIMP) and MLH1 methylation status. Here, we tested the prognostic value of this model in stage II colorectal cancer (CRC) patients. Tumors were assigned to CIMP+/MLH1-unmethylated (MLH1-U), CIMP+/MLH1-methylated (MLH1-M), CIMP−/MLH1-U, or CIMP−/MLH1-M groups. Age, tumor location, lymphovascular invasion, and mucin production differed among the four patient subgroups, and CIMP+/MLH1-U tumors were more likely to have lymphovascular invasion and mucin production. Kaplan-Meier analyses revealed differences in both disease-free survival (DFS) and overall survival (OS) among the four groups. In a multivariate analysis, CIMP/MLH1 methylation status was predictive of both DFS and OS, and DFS and OS were shortest in CIMP+/MLH1-U stage II CRC patients. These results suggest that tumor subtype classification based on the combination of CIMP and MLH1 methylation status is informative in stage II CRC patients, and that CIMP+/MLH1-U tumors exhibit aggressive features and are associated with poor clinical outcomes. PMID:27880934

Tumors with unmethylated MLH1 and the CpG island methylator phenotype are associated with a poor prognosis in stage II colorectal cancer patients.

PubMed

Fu, Tao; Liu, Yanliang; Li, Kai; Wan, Weiwei; Pappou, Emmanouil P; Iacobuzio-Donahue, Christine A; Kerner, Zachary; Baylin, Stephen B; Wolfgang, Christopher L; Ahuja, Nita

2016-12-27

We previously developed a novel tumor subtype classification model for duodenal adenocarcinomas based on a combination of the CpG island methylator phenotype (CIMP) and MLH1 methylation status. Here, we tested the prognostic value of this model in stage II colorectal cancer (CRC) patients. Tumors were assigned to CIMP+/MLH1-unmethylated (MLH1-U), CIMP+/MLH1-methylated (MLH1-M), CIMP-/MLH1-U, or CIMP-/MLH1-M groups. Age, tumor location, lymphovascular invasion, and mucin production differed among the four patient subgroups, and CIMP+/MLH1-U tumors were more likely to have lymphovascular invasion and mucin production. Kaplan-Meier analyses revealed differences in both disease-free survival (DFS) and overall survival (OS) among the four groups. In a multivariate analysis, CIMP/MLH1 methylation status was predictive of both DFS and OS, and DFS and OS were shortest in CIMP+/MLH1-U stage II CRC patients. These results suggest that tumor subtype classification based on the combination of CIMP and MLH1 methylation status is informative in stage II CRC patients, and that CIMP+/MLH1-U tumors exhibit aggressive features and are associated with poor clinical outcomes.

Two stage launch vehicle

NASA Technical Reports Server (NTRS)

1987-01-01

The Advanced Space Design project for 1986-87 was the design of a two stage launch vehicle, representing a second generation space transportation system (STS) which will be needed to support the space station. The first stage is an unmanned winged booster which is fully reusable with a fly back capability. It has jet engines so that it can fly back to the landing site. This adds safety as well as the flexibility to choose alternate landing sites. There are two different second stages. One of the second stages is a manned advanced space shuttle called Space Shuttle II. Space Shuttle II has a payload capability of delivering 40,000 pounds to the space station in low Earth orbit (LEO), and returning 40,000 pounds to Earth. Servicing the space station makes the ability to return a heavy payload to Earth as important as being able to launch a heavy payload. The other second stage is an unmanned heavy lift cargo vehicle with ability to deliver 150,000 pounds of payload to LEO. This vehicle will not return to Earth; however, the engines and electronics can be removed and returned to Earth in the Space Shuttle II. The rest of the vehicle can then be used on orbit for storage or raw materials, supplies, and space manufactured items awaiting transport back to Earth.

A scoring system based on artificial neural network for predicting 10-year survival in stage II A colon cancer patients after radical surgery.

PubMed

Peng, Jian-Hong; Fang, Yu-Jing; Li, Cai-Xia; Ou, Qing-Jian; Jiang, Wu; Lu, Shi-Xun; Lu, Zhen-Hai; Li, Pei-Xing; Yun, Jing-Ping; Zhang, Rong-Xin; Pan, Zhi-Zhong; Wan, De Sen

2016-04-19

Nearly 20% patients with stage II A colon cancer will develop recurrent disease post-operatively. The present study aims to develop a scoring system based on Artificial Neural Network (ANN) model for predicting 10-year survival outcome. The clinical and molecular data of 117 stage II A colon cancer patients from Sun Yat-sen University Cancer Center were used for training set and test set; poor pathological grading (score 49), reduced expression of TGFBR2 (score 33), over-expression of TGF-β (score 45), MAPK (score 32), pin1 (score 100), β-catenin in tumor tissue (score 50) and reduced expression of TGF-β in normal mucosa (score 22) were selected as the prognostic risk predictors. According to the developed scoring system, the patients were divided into 3 subgroups, which were supposed with higher, moderate and lower risk levels. As a result, for the 3 subgroups, the 10-year overall survival (OS) rates were 16.7%, 62.9% and 100% (P < 0.001); and the 10-year disease free survival (DFS) rates were 16.7%, 61.8% and 98.8% (P < 0.001) respectively. It showed that this scoring system for stage II A colon cancer could help to predict long-term survival and screen out high-risk individuals for more vigorous treatment.

The J-2X Upper Stage Engine: From Design to Hardware

NASA Technical Reports Server (NTRS)

Byrd, Thomas

2010-01-01

NASA is well on its way toward developing a new generation of launch vehicles to support of national space policy to retire the Space Shuttle fleet, complete the International Space Station, and return to the Moon as the first step in resuming this nation s exploration of deep space. The Constellation Program is developing the launch vehicles, spacecraft, surface systems, and ground systems to support those plans. Two launch vehicles will support those ambitious plans the Ares I and Ares V. (Figure 1) The J-2X Upper Stage Engine is a critical element of both of these new launchers. This paper will provide an overview of the J-2X design background, progress to date in design, testing, and manufacturing. The Ares I crew launch vehicle will lift the Orion crew exploration vehicle and up to four astronauts into low Earth orbit (LEO) to rendezvous with the space station or the first leg of mission to the Moon. The Ares V cargo launch vehicle is designed to lift a lunar lander into Earth orbit where it will be docked with the Orion spacecraft, and provide the thrust for the trans-lunar journey. While these vehicles bear some visual resemblance to the 1960s-era Saturn vehicles that carried astronauts to the Moon, the Ares vehicles are designed to carry more crew and more cargo to more places to carry out more ambitious tasks than the vehicles they succeed. The government/industry team designing the Ares rockets is mining a rich history of technology and expertise from the Shuttle, Saturn and other programs and seeking commonality where feasible between the Ares crew and cargo rockets as a way to minimize risk, shorten development times, and live within the budget constraints of its original guidance.

Utility of palmatolepids and icriodontids in recognizing Upper Devonian Series, Stage, and possible substage boundaries

USGS Publications Warehouse

Ziegler, W.; Sandberg, C.A.

2000-01-01

Conodonts are accepted internationally to define Devonian Series and Stage boundaries. Hence, the evolution and taxonomy of pelagic palmatolepids, primarily Palmatolepis and its direct ancestor Mesotaxis, and shallow-water icriodontids, Icriodus, Pelekysgnathus, and "Icriodus", are the major tools for recognizing subdivisions of the Upper Devonian. Palmatolepids are the basis for the Late Devonian Standard Conodont Zonation (ZIEGLER & SANDBERG 1990), whereas icriodontids are the basis for the alternative, integrated shallow-water zonation (SANDBERG & DREESEN 1984). However, an alternative palmatolepid taxonomy for some Frasnian species has been employed recently by some conodont workers using the Montagne Noire (M.N.) zonation, shape analyses of Pa elements, and multielement reconstructions of KLAPPER (1989), KLAPPER & FOSTER (1993); and KLAPPER et al. (1996). Herein, the evolution of palmatolepids and icriodontids is summarized in terms of our zonation and some of the taxonomic differences with the alternative M.N. zonation are exemplified. One of the problems in relating the Standard and M.N. zonations arises from previous errors of interpretation and drafting of the Martenberg section in Germany. This section was designated the reference section for the Frasnian transitans through jamieae Zones by ZIEGLER & SANDBERG (1990). Herein, the early and middle Frasnian zonal boundaries at Martenberg are improved by re-study of our old and recent collections from three profiles, spaced only 4 m apart. Serious problems exist with the Global Stratotype Sections and Points (GSSP's), selected by the Subcommission on Devonian Stratigraphy, following the paleontologic definition of the bases of the Frasnian, Famennian, and Tournaisian Stages, because of the difficulty in making global correlations from these GSSP's. Our summary of these problems should be helpful if future workers decide to relocate these GSSP's.

A Mechanism for Upper Airway Stability during Slow Wave Sleep

PubMed Central

McSharry, David G.; Saboisky, Julian P.; DeYoung, Pam; Matteis, Paul; Jordan, Amy S.; Trinder, John; Smales, Erik; Hess, Lauren; Guo, Mengshuang; Malhotra, Atul

2013-01-01

Study Objectives: The severity of obstructive sleep apnea is diminished (sometimes markedly) during slow wave sleep (SWS). We sought to understand why SWS stabilizes the upper airway. Increased single motor unit (SMU) activity of the major upper airway dilating muscle (genioglossus) should improve upper airway stability. Therefore, we hypothesized that genioglossus SMUs would increase their activity during SWS in comparison with Stage N2 sleep. Design: The activity of genioglossus SMUs was studied on both sides of the transition between Stage N2 sleep and SWS. Setting: Sleep laboratory. Participants: Twenty-nine subjects (age 38 ± 13 yr, 17 males) were studied. Intervention: SWS. Measurement and Results: Subjects slept overnight with fine-wire electrodes in their genioglossus muscles and with full polysomnographic and end tidal carbon dioxide monitors. Fifteen inspiratory phasic (IP) and 11 inspiratory tonic (IT) units were identified from seven subjects and these units exhibited significantly increased inspiratory discharge frequencies during SWS compared with Stage N2 sleep. The peak discharge frequency of the inspiratory units (IP and IT) was 22.7 ± 4.1 Hz in SWS versus 20.3 ± 4.5 Hz in Stage N2 (P < 0.001). The IP units also fired for a longer duration (expressed as a percentage of inspiratory time) during SWS (104.6 ± 39.5 %TI) versus Stage N2 sleep (82.6 ± 39.5 %TI, P < 0.001). The IT units fired faster during expiration in SWS (14.2 ± 1.8 Hz) versus Stage N2 sleep (12.6 ± 3.1 Hz, P = 0.035). There was minimal recruitment or derecruitment of units between SWS and Stage N2 sleep. Conclusion: Increased genioglossus SMU activity likely makes the airway more stable and resistant to collapse throughout the respiratory cycle during SWS. Citation: McSharry DG; Saboisky JP; DeYoung P; Matteis P; Jordan AS; Trinder J; Smales E; Hess L; Guo M; Malhotra A. A mechanism for upper airway stability during slow wave sleep. SLEEP 2013;36(4):555-563. PMID:23565001

Value of Surveillance Studies for Patients With Stage I to II Diffuse Large B-Cell Lymphoma in the Rituximab Era

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hiniker, Susan M.; Pollom, Erqi L.; Khodadoust, Michael S.

2015-05-01

Background: The role of surveillance studies in limited-stage diffuse large B-cell lymphoma (DLBCL) in the rituximab era has not been well defined. We sought to evaluate the use of imaging (computed tomography [CT] and positron emission tomography [PET]-CT) scans and lactate dehydrogenase (LDH) in surveillance of patients with stage I to II DLBCL. Methods: A retrospective analysis was performed of patients who received definitive treatment between 2000 and 2013. Results: One hundred sixty-two consecutive patients with stage I to II DLBCL were treated with chemotherapy +/− rituximab, radiation, or combined modality therapy. The 5-year rates of overall survival (OS) and freedommore » from progression (FFP) were 81.2% and 80.8%, respectively. Of the 162 patients, 124 (77%) were followed up with at least 1 surveillance PET scan beyond end-of-treatment scans; of those, 94 of 124 (76%) achieved a complete metabolic response on PET scan after completion of chemotherapy, and this was associated with superior FFP (P=.01, HR=0.3) and OS (P=.01, HR 0.3). Eighteen patients experienced relapse after initial response to therapy. Nine relapses were initially suspected by surveillance imaging studies (8 PET, 1 CT), and 9 were suspected clinically (5 by patient-reported symptoms and 4 by symptoms and physical examination). No relapses were detected by surveillance LDH. The median duration from initiation of treatment to relapse was 14.3 months among patients with relapses suspected by imaging, and 59.8 months among patients with relapses suspected clinically (P=.077). There was no significant difference in OS from date of first therapy or OS after relapse between patients whose relapse was suspected by imaging versus clinically. Thirteen of 18 patients underwent successful salvage therapy after relapse. Conclusions: A complete response on PET scan immediately after initial chemotherapy is associated with superior FFP and OS in stage I to II DLBCL. The use of PET scans as

Impact of variable river water stage on the simulation of groundwater-river interactions over the Upper Rhine Graben hydrosystem

NASA Astrophysics Data System (ADS)

Habets, F.; Vergnes, J.

2013-12-01

The Upper Rhine alluvial aquifer is an important transboundary water resource which is particularly vulnerable to pollution from the rivers due to anthropogenic activities. A realistic simulation of the groundwater-river exchanges is therefore of crucial importance for effective management of water resources, and hence is the main topic of the NAPROM project financed by the French Ministry of Ecology. Characterization of these fluxes in term of quantity and spatio-temporal variability depends on the choice made to represent the river water stage in the model. Recently, a couple surface-subsurface model has been applied to the whole aquifer basin. The river stage was first chosen to be constant over the major part of the basin for the computation of the groundwater-river interactions. The present study aims to introduce a variable river water stage to better simulate these interactions and to quantify the impact of this process over the simulated hydrological variables. The general modeling strategy is based on the Eau-Dyssée modeling platform which couples existing specialized models to address water resources and quality in regional scale river basins. In this study, Eau-Dyssée includes the RAPID river routing model and the SAM hydrogeological model. The input data consist in runoff and infiltration coming from a simulation of the ISBA land surface scheme covering the 1986-2003 period. The QtoZ module allows to calculate river stage from simulated river discharges, which is then used to calculate the exchanges between aquifer units and river. Two approaches are compared. The first one uses rating curves derived from observed river discharges and river stages. The second one is based on the Manning's formula. Manning's parameters are defined with geomorphological parametrizations and topographic data based on Digital Elevation Model (DEM). First results show a relatively good agreement between observed and simulated river water height. Taking into account a

Lymph node ratio may predict relapse free survival and overall survival in patients with stage II & III colorectal carcinoma.

PubMed

Zekri, Jamal; Ahmad, Imran; Fawzy, Ehab; Elkhodary, Tawfik R; Al-Gahmi, Aboelkhair; Hassouna, Ashraf; El Sayed, Mohamed E; Ur Rehman, Jalil; Karim, Syed M; Bin Sadiq, Bakr

2015-01-01

Lymph node ratio (LNR) defined as the number of lymph nodes (LNs) involved with metastases divided by number of LNs examined, has been shown to be an independent prognostic factor in breast, stomach and various other solid tumors. Its significance as a prognostic determinant in colorectal cancer (CRC) is still under investigation. This study investigated the prognostic value of LNR in patients with resected CRC. We retrospectively ex- amined 145 patients with stage II & III CRC diagnosed and treated at a single institution during 9 years pe- riod. Patients were grouped according to LNR in three groups. Group 1; LNR < 0.05, Group 2; LNR = 0.05-0.19 & Group 3 > 0.19. Chi square, life table analysis and multivariate Cox regression were used for statistical analysis. On multivariate analysis, number of involved LNs (NILN) (HR = 1.15, 95% CI 1.055-1.245; P = 0.001) and pathological T stage (P = 0.002) were statistically significant predictors of relapse free survival (RFS). LNR as a continuous variable (but not as a categorical variable) was statistically significant predictor of RFS (P = 0.02). LNR was also a statistically significant predictor of overall survival (OS) (P = 0.02). LNR may predict RFS and OS in patients with resected stage II & III CRC. Studies with larger cohorts and longer follow up are needed to further examine and validate theprognostic value of LNR.

Psychosexual Intervention in Patients With Stage I-III Gynecologic or Breast Cancer

ClinicalTrials.gov

2018-05-25

Ovarian Sarcoma; Ovarian Stromal Cancer; Stage I Uterine Sarcoma; Stage I Vaginal Cancer; Stage I Vulvar Cancer; Stage IA Cervical Cancer; Stage IA Endometrial Carcinoma; Stage IA Fallopian Tube Cancer; Stage IA Ovarian Epithelial Cancer; Stage IA Ovarian Germ Cell Tumor; Stage IA Primary Peritoneal Cavity Cancer; Stage IB Cervical Cancer; Stage IB Endometrial Carcinoma; Stage IB Fallopian Tube Cancer; Stage IB Ovarian Epithelial Cancer; Stage IB Ovarian Germ Cell Tumor; Stage IB Primary Peritoneal Cavity Cancer; Stage IC Fallopian Tube Cancer; Stage IC Ovarian Epithelial Cancer; Stage IC Ovarian Germ Cell Tumor; Stage IC Primary Peritoneal Cavity Cancer; Stage II Endometrial Carcinoma; Stage II Gestational Trophoblastic Tumor; Stage II Uterine Sarcoma; Stage II Vaginal Cancer; Stage II Vulvar Cancer; Stage IIA Cervical Cancer; Stage IIA Fallopian Tube Cancer; Stage IIA Ovarian Epithelial Cancer; Stage IIA Ovarian Germ Cell Tumor; Stage IIA Primary Peritoneal Cavity Cancer; Stage IIB Cervical Cancer; Stage IIB Fallopian Tube Cancer; Stage IIB Ovarian Epithelial Cancer; Stage IIB Ovarian Germ Cell Tumor; Stage IIB Primary Peritoneal Cavity Cancer; Stage IIC Fallopian Tube Cancer; Stage IIC Ovarian Epithelial Cancer; Stage IIC Ovarian Germ Cell Tumor; Stage IIC Primary Peritoneal Cavity Cancer; Stage III Gestational Trophoblastic Tumor; Stage III Uterine Sarcoma; Stage III Vaginal Cancer; Stage III Vulvar Cancer; Stage IIIA Cervical Cancer; Stage IIIA Endometrial Carcinoma; Stage IIIA Fallopian Tube Cancer; Stage IIIA Ovarian Epithelial Cancer; Stage IIIA Ovarian Germ Cell Tumor; Stage IIIA Primary Peritoneal Cavity Cancer; Stage IIIB Cervical Cancer; Stage IIIB Endometrial Carcinoma; Stage IIIB Fallopian Tube Cancer; Stage IIIB Ovarian Epithelial Cancer; Stage IIIB Ovarian Germ Cell Tumor; Stage IIIB Primary Peritoneal Cavity Cancer; Stage IIIC Endometrial Carcinoma; Stage IIIC Fallopian Tube Cancer; Stage IIIC Ovarian Epithelial Cancer; Stage IIIC Ovarian Germ Cell

Sleep structure: a new diagnostic tool for stage determination in sleeping sickness.

PubMed

Buguet, Alain; Bisser, Sylvie; Josenando, Théophile; Chapotot, Florian; Cespuglio, Raymond

2005-01-01

Human African trypanosomiasis (HAT), due to the transmission of Trypanosoma brucei (T. b.) gambiense and T. b. rhodesiense by tsetse flies, is re-emerging in inter-tropical Africa. It evolves from the hemolymphatic Stage I to the meningo-encephalitic Stage II. The latter is generally treated with melarsoprol, an arseniate provoking often a deadly encephalopathy. A precise determination of the HAT evolution stage is therefore crucial. Stage II patients show: (i) a deregulation of the 24-h distribution of the sleep-wake alternation; (ii) an alteration of the sleep structure, with frequent sleep onset rapid eye movement (REM) periods (SOREMPs). Gambian HAT was diagnosed in eight patients (four, Stage II; three, Stage I; one, "intermediate" case) at the trypanosomiasis clinic at Viana (Angola). Continuous 48-h polysomnography was recorded on Oxford Medilog 9000-II portable systems before and after treatment with melarsoprol (Stage II) or pentamidine (Stage I and "intermediate" stage). Sleep traces were visually analyzed in 20-s epochs using the PRANA software. Stage II patients showed the complete sleep-wake syndrome, partly reversed by melarsoprol 1 month later. Two Stage I patients did not experience any of these alterations. However, the "intermediate" and one Stage I patients exhibited sleep disruptions and/or SOREMPs, persistent after pentamidine treatment. Polysomnography may represent a diagnostic tool to distinguish the two stages of HAT. Especially, SOREMPs appear shortly after the central nervous system invasion by trypanosomes. The reversibility of the sleep-wake cycle and sleep structure alterations after appropriate treatment constitutes the basis of an evaluation of the healing process.

Validated Competing Event Model for the Stage I-II Endometrial Cancer Population

DOE Office of Scientific and Technical Information (OSTI.GOV)

Carmona, Ruben; Gulaya, Sachin; Murphy, James D.

2014-07-15

Purpose/Objectives(s): Early-stage endometrial cancer patients are at higher risk of noncancer mortality than of cancer mortality. Competing event models incorporating comorbidity could help identify women most likely to benefit from treatment intensification. Methods and Materials: 67,397 women with stage I-II endometrioid adenocarcinoma after total hysterectomy diagnosed from 1988 to 2009 were identified in Surveillance, Epidemiology, and End Results (SEER) and linked SEER-Medicare databases. Using demographic and clinical information, including comorbidity, we sought to develop and validate a risk score to predict the incidence of competing mortality. Results: In the validation cohort, increasing competing mortality risk score was associated with increasedmore » risk of noncancer mortality (subdistribution hazard ratio [SDHR], 1.92; 95% confidence interval [CI], 1.60-2.30) and decreased risk of endometrial cancer mortality (SDHR, 0.61; 95% CI, 0.55-0.78). Controlling for other variables, Charlson Comorbidity Index (CCI) = 1 (SDHR, 1.62; 95% CI, 1.45-1.82) and CCI >1 (SDHR, 3.31; 95% CI, 2.74-4.01) were associated with increased risk of noncancer mortality. The 10-year cumulative incidences of competing mortality within low-, medium-, and high-risk strata were 27.3% (95% CI, 25.2%-29.4%), 34.6% (95% CI, 32.5%-36.7%), and 50.3% (95% CI, 48.2%-52.6%), respectively. With increasing competing mortality risk score, we observed a significant decline in omega (ω), indicating a diminishing likelihood of benefit from treatment intensification. Conclusion: Comorbidity and other factors influence the risk of competing mortality among patients with early-stage endometrial cancer. Competing event models could improve our ability to identify patients likely to benefit from treatment intensification.« less

Addition of Rituximab to Involved-Field Radiation Therapy Prolongs Progression-free Survival in Stage I-II Follicular Lymphoma: Results of a Multicenter Study

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ruella, Marco; Center for Cellular Immunotherapies, Perelman School of Medicine, University of Pennsylvania, Philadelphia; Filippi, Andrea Riccardo

Purpose: Rituximab (Rit) therapy added to involved-field radiation therapy (RT) has been proposed as an effective treatment for stage I-II follicular lymphoma (FL). The results of an observational multicenter study on the Rit-RT combination in limited-stage FL are here reported. Methods and Materials: Data have been collected from 2 consecutive cohorts of 94 patients with stage I-II FL treated between 1985 and 2011 at 5 Italian institutions. All patients had grade 1-3a FL, a median age of 54 years (range: 25-82). The first 51 patients received RT alone (control group), while the subsequent series of 43 patients received 4 rituximab coursesmore » (375 mg/m{sup 2}, days 1, 8, 15, 22) before RT (Rit-RT). Molecular disease was evaluated by nested bcl-2/IgH PCR or clonal IgH rearrangement was available in 33 Rit-RT patients. Results: At a median follow-up of 10.9 years (range: 1.8-22.9), the 10-year progression-free survival (PFS) and overall survival (OS) projections for the whole cohort were 57% and 87.5%, respectively. The 10-year PFS was significantly longer (P<.05) in the Rit-RT group (64.6%) compared to RT alone (50.7%), whereas the 10-year OS projections were not significantly different. On bivariate analysis controlling for stage, there was only a trend toward improved PFS for Rit-RT (HR, 0.55; P=.081). Follicular lymphoma international prognostic index and age were associated with OS but not with PFS on Cox regression analysis. Bone marrow molecular analysis showing PCR positivity at diagnosis was strongly associated with relapse risk upon univariate and multivariate analysis. Conclusions: This multicenter observational study suggests a potential benefit of adding rituximab to radiation therapy for stage I-II FL. The results of the currently ongoing randomized studies are required to confirm these results. The study underlines the importance of molecular disease monitoring also for patient with limited-stage disease.« less

Interim analysis of postoperative chemoradiotherapy with capecitabine and oxaliplatin versus capecitabine alone for pathological stage II and III rectal cancer: a randomized multicenter phase III trial.

PubMed

Feng, Yan-Ru; Zhu, Yuan; Liu, Lu-Ying; Wang, Wei-Hu; Wang, Shu-Lian; Song, Yong-Wen; Wang, Xin; Tang, Yuan; Liu, Yue-Ping; Ren, Hua; Fang, Hui; Zhang, Shi-Ping; Liu, Xin-Fan; Yu, Zi-Hao; Li, Ye-Xiong; Jin, Jing

2016-05-03

The aim of this study is to present an interim analysis of a phase III trial (NCT00714077) of postoperative concurrent capecitabine and radiotherapy with or without oxaliplatin for pathological stage II and III rectal cancer. Patients with pathologically confirmed stage II and III rectal cancer were randomized to either radiotherapy with concurrent capecitabine (Cap-RT group) or with capecitabine and oxaliplatin (Capox-RT group). The primary endpoint was 3-year disease-free survival rate (DFS). The 3-year DFS rate was 73.9% in the Capox-RT group and 71.6% in the Cap-RT group (HR 0.92, p = 0.647), respectively. No significant difference was observed in overall survival, cumulative incidence of local recurrence and distant metastasis between the two groups (p > 0.05). More grade 3-4 acute toxicity was observed in the Capox-RT group than in the Cap-RT group (38.1% vs. 29.2%, p = 0.041). Inclusion of oxaliplatin in the capecitabine-based postoperative regimen did not improve DFS but increased toxicities for pathological stage II and III rectal cancer in this interim analysis.

Validation study of a quantitative multigene reverse transcriptase-polymerase chain reaction assay for assessment of recurrence risk in patients with stage II colon cancer.

PubMed

Gray, Richard G; Quirke, Philip; Handley, Kelly; Lopatin, Margarita; Magill, Laura; Baehner, Frederick L; Beaumont, Claire; Clark-Langone, Kim M; Yoshizawa, Carl N; Lee, Mark; Watson, Drew; Shak, Steven; Kerr, David J

2011-12-10

We developed quantitative gene expression assays to assess recurrence risk and benefits from chemotherapy in patients with stage II colon cancer. We sought validation by using RNA extracted from fixed paraffin-embedded primary colon tumor blocks from 1,436 patients with stage II colon cancer in the QUASAR (Quick and Simple and Reliable) study of adjuvant fluoropyrimidine chemotherapy versus surgery alone. A recurrence score (RS) and a treatment score (TS) were calculated from gene expression levels of 13 cancer-related genes (n = 7 recurrence genes and n = 6 treatment benefit genes) and from five reference genes with prespecified algorithms. Cox proportional hazards regression models and log-rank methods were used to analyze the relationship between the RS and risk of recurrence in patients treated with surgery alone and between TS and benefits of chemotherapy. Risk of recurrence was significantly associated with RS (hazard ratio [HR] per interquartile range, 1.38; 95% CI, 1.11 to 1.74; P = .004). Recurrence risks at 3 years were 12%, 18%, and 22% for predefined low, intermediate, and high recurrence risk groups, respectively. T stage (HR, 1.94; P < .001) and mismatch repair (MMR) status (HR, 0.31; P < .001) were the strongest histopathologic prognostic factors. The continuous RS was associated with risk of recurrence (P = .006) beyond these and other covariates. There was no trend for increased benefit from chemotherapy at higher TS (P = .95). The continuous 12-gene RS has been validated in a prospective study for assessment of recurrence risk in patients with stage II colon cancer after surgery and provides prognostic value that complements T stage and MMR. The TS was not predictive of chemotherapy benefit.

ON COMPUTING UPPER LIMITS TO SOURCE INTENSITIES

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kashyap, Vinay L.; Siemiginowska, Aneta; Van Dyk, David A.

2010-08-10

A common problem in astrophysics is determining how bright a source could be and still not be detected in an observation. Despite the simplicity with which the problem can be stated, the solution involves complicated statistical issues that require careful analysis. In contrast to the more familiar confidence bound, this concept has never been formally analyzed, leading to a great variety of often ad hoc solutions. Here we formulate and describe the problem in a self-consistent manner. Detection significance is usually defined by the acceptable proportion of false positives (background fluctuations that are claimed as detections, or Type I error),more » and we invoke the complementary concept of false negatives (real sources that go undetected, or Type II error), based on the statistical power of a test, to compute an upper limit to the detectable source intensity. To determine the minimum intensity that a source must have for it to be detected, we first define a detection threshold and then compute the probabilities of detecting sources of various intensities at the given threshold. The intensity that corresponds to the specified Type II error probability defines that minimum intensity and is identified as the upper limit. Thus, an upper limit is a characteristic of the detection procedure rather than the strength of any particular source. It should not be confused with confidence intervals or other estimates of source intensity. This is particularly important given the large number of catalogs that are being generated from increasingly sensitive surveys. We discuss, with examples, the differences between these upper limits and confidence bounds. Both measures are useful quantities that should be reported in order to extract the most science from catalogs, though they answer different statistical questions: an upper bound describes an inference range on the source intensity, while an upper limit calibrates the detection process. We provide a recipe for computing

A systematic review and meta-analysis of the safety, feasibility and effect of exercise in women with stage II+ breast cancer.

PubMed

Singh, Ben; Spence, Rosalind R; Steele, Megan L; Sandler, Carolina X; Peake, Jonathan M; Hayes, Sandra C

2018-05-03

To systematically evaluate the safety, feasibility and effect of exercise among women with stage II+ breast cancer. CINAHL, Cochrane, Ebscohost, MEDLINE, Pubmed, ProQuest Health and Medical Complete, ProQuest Nursing and Allied Health Source, Science Direct and SPORTDiscus were searched for articles published prior to March 1, 2017. Randomised, controlled, exercise trials involving at least 50% of women diagnosed with stage II+ breast cancer were included. Risk of bias was assessed and adverse event severity was classified using the Common Terminology Criteria. Feasibility was evaluated by computing median (range) recruitment, withdrawal and adherence rates. Meta-analyses were performed to evaluate exercise safety and effects on health outcomes only. The influence of intervention characteristics (mode, supervision, duration and timing) on exercise outcomes were also explored. There were no differences in adverse events between exercise and usual care (risk difference: <0.01 [95% CI: -0.01, 0.01]), p=0.38). Median recruitment rate was 56% (1%-96%), withdrawal rate was 10% (0%-41%) and adherence rate was 82% (44%-99%). Safety and feasibility outcomes were similar, irrespective of exercise mode, supervision, duration, or timing. Effects of exercise for quality of life, fitness, fatigue, strength, anxiety, depression, body mass index and waist circumference compared with usual care were significant (standardised mean difference range: 0.17-0.77, p<0.05). The findings support the safety, feasibility and effects of exercise for those with stage II+ breast cancer, suggesting that national and international exercise guidelines appear generalizable to women with local, regional and distant breast cancer. Copyright © 2018. Published by Elsevier Inc.

Installation Restoration Program. Phase II--Confirmation/Quantification. Stage 1.

DTIC Science & Technology

1985-03-01

four phases. Phase I, Initial Assessment/ Records Search, is designed to identify possible hazardous waste contami- nated sites and potential...7 71 -. - - IL’ -, 1% 33 AihlIII Is 33 n~iL t iiC UII! ii CL C LU 1-3, Phase II, Confirmation and Quantification, is designed to confirm the...additional monitoring data upon which design of mitigative actions are based. In Phase III, Technology Base Development, appropriate technology is selected and

Hospital-level Variation in Utilization of Surgery for Clinical Stage I-II Pancreatic Adenocarcinoma.

PubMed

Swords, Douglas S; Mulvihill, Sean J; Skarda, David E; Finlayson, Samuel R G; Stoddard, Gregory J; Ott, Mark J; Firpo, Matthew A; Scaife, Courtney L

2017-07-11

To (1) evaluate rates of surgery for clinical stage I-II pancreatic ductal adenocarcinoma (PDAC), (2) identify predictors of not undergoing surgery, (3) quantify the degree to which patient- and hospital-level factors explain differences in hospital surgery rates, and (4) evaluate the association between adjusted hospital-specific surgery rates and overall survival (OS) of patients treated at different hospitals. Curative-intent surgery for potentially resectable PDAC is underutilized in the United States. Retrospective cohort study of patients ≤85 years with clinical stage I-II PDAC in the 2004 to 2014 National Cancer Database. Mixed effects multivariable models were used to characterize hospital-level variation across quintiles of hospital surgery rates. Multivariable Cox proportional hazards models were used to estimate the effect of adjusted hospital surgery rates on OS. Of 58,553 patients without contraindications or refusal of surgery, 63.8% underwent surgery, and the rate decreased from 2299/3528 (65.2%) in 2004 to 4412/7092 (62.2%) in 2014 (P < 0.001). Adjusted hospital rates of surgery varied 6-fold (11.4%-70.9%). Patients treated at hospitals with higher rates of surgery had better unadjusted OS (median OS 10.2, 13.3, 14.2, 16.5, and 18.4 months in quintiles 1-5, respectively, P < 0.001, log-rank). Treatment at hospitals in lower surgery rate quintiles 1-3 was independently associated with mortality [Hazard ratio (HR) 1.10 (1.01, 1.21), HR 1.08 (1.02, 1.15), and HR 1.09 (1.04, 1.14) for quintiles 1-3, respectively, compared with quintile 5] after adjusting for patient factors, hospital type, and hospital volume. Quality improvement efforts are needed to help hospitals with low rates of surgery ensure that their patients have access to appropriate surgery.

Evaluation of clinical and histologic factors associated with survival time in dogs with stage II splenic hemangiosarcoma treated by splenectomy and adjuvant chemotherapy: 30 cases (2011-2014).

PubMed

Moore, Antony S; Rassnick, Kenneth M; Frimberger, Angela E

2017-09-01

OBJECTIVE To determine histologic and clinical factors associated with survival time in dogs with stage II splenic hemangiosarcoma treated by splenectomy and a chemotherapy protocol in which an anthracycline was alternated with lomustine. DESIGN Retrospective case series. ANIMALS 30 dogs with stage II splenic hemangiosarcoma. PROCEDURES Medical records of 3 facilities were reviewed to identify dogs treated for stage II splenic hemangiosarcoma between June 2011 and October 2014. Information collected included signalment, disease staging data, whether anemia was present, date of splenectomy, chemotherapy protocol, adverse effects, and date of death or last follow-up. Histologic slides were reviewed and scored by pathologists. Associations between variables of interest and survival data were evaluated statistically. RESULTS Median survival time for all dogs was 158 days (range, 55 to 560 days), and the 1-year survival rate was 16%. On multivariate analysis, only the histologically determined mitotic score was significantly associated with survival time. The median survival time of 292 days for dogs with a mitotic score of 0 (< 11 mitoses/10 hpf; n = 9) was significantly longer than that for dogs with higher scores (indicating higher mitotic rates); the 1-year survival rate for these dogs was 42%. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that future studies should take histologic factors, particularly mitotic rate, as well as tumor stage into account when assessing treatment effects on survival time of dogs with splenic hemangiosarcoma.

Progress on the J-2X Upper Stage Engine for the Ares I Crew Launch Vehicle and the Ares V Cargo Launch Vehicle

NASA Technical Reports Server (NTRS)

Byrd, Thomas D.; Kynard, Michael .

2007-01-01

NASA's Vision for Exploration requires a safe, reliable, affordable upper stage engine to power the Ares I Crew Launch Vehicle (CLV) and the Ares V Cargo Launch Vehicle. The J-2X engine is being developed for that purpose, epitomizing NASA's philosophy of employing legacy knowledge, heritage hardware, and commonality to carry the next generation of explorers into low-Earth orbit and out into the solar system This presentation gives top-level details on accomplishments to date and discusses forward work necessary to bring the J-2X engine to the launch pad.

Recommendations for clinical staging (cTNM) of cancer of the esophagus and esophagogastric junction for the 8th edition AJCC/UICC staging manuals.

PubMed

Rice, Thomas W; Ishwaran, Hemant; Blackstone, Eugene H; Hofstetter, Wayne L; Kelsen, David P; Apperson-Hansen, Carolyn

2016-11-01

We report analytic and consensus processes that produced recommendations for clinical stage groups (cTNM) of esophageal and esophagogastric junction cancer for the AJCC/UICC cancer staging manuals, 8th edition. The Worldwide Esophageal Cancer Collaboration (WECC) provided data on 22,123 clinically staged patients with epithelial esophageal cancers. Risk-adjusted survival for each patient was developed using random survival forest analysis from which (1) data-driven clinical stage groups were identified wherein survival decreased monotonically and was distinctive between and homogeneous within groups and (2) data-driven anatomic clinical stage groups based only on cTNM. The AJCC Upper GI Task Force, by smoothing, simplifying, expanding, and assessing clinical applicability, produced (3) consensus clinical stage groups. Compared with pTNM, cTNM survival was "pinched," with poorer survival for early cStage groups and better survival for advanced ones. Histologic grade was distinctive for data-driven grouping of cT2N0M0 squamous cell carcinoma (SCC) and cT1-2N0M0 adenocarcinoma, but consensus removed it. Grouping was different by histopathologic cell type. For SCC, cN0-1 was distinctive for cT3 but not cT1-2, and consensus removed cT4 subclassification and added subgroups 0, IVA, and IVB. For adenocarcinoma, N0-1 was distinctive for cT1-2 but not cT3-4a, cStage II subgrouping was necessary (T1N1M0 [IIA] and T2N0M0 [IIB]), advanced cancers cT3-4aN0-1M0 plus cT2N1M0 comprised cStage III, and consensus added subgroups 0, IVA, and IVB. Treatment decisions require accurate cStage, which differs from pStage. Understaging and overstaging are problematic, and additional factors, such as grade, may facilitate treatment decisions and prognostication until clinical staging techniques are uniformly applied and improved. © 2016 International Society for Diseases of the Esophagus.

Recommendations for clinical staging (cTNM) of cancer of the esophagus and esophagogastric junction for the 8th edition AJCC/UICC staging manuals

PubMed Central

Rice, Thomas W.; Ishwaran, Hemant; Blackstone, Eugene H.; Hofstetter, Wayne L.; Kelsen, David P.; Apperson-Hansen, Carolyn

2017-01-01

SUMMARY We report analytic and consensus processes that produced recommendations for clinical stage groups (cTNM) of esophageal and esophagogastric junction cancer for the AJCC/UICC cancer staging manuals, 8th edition. The Worldwide Esophageal Cancer Collaboration (WECC) provided data on 22,123 clinically staged patients with epithelial esophageal cancers. Risk-adjusted survival for each patient was developed using random survival forest analysis from which (1) data-driven clinical stage groups were identified wherein survival decreased monotonically and was distinctive between and homogeneous within groups and (2) data-driven anatomic clinical stage groups based only on cTNM. The AJCC Upper GI Task Force, by smoothing, simplifying, expanding, and assessing clinical applicability, produced (3) consensus clinical stage groups. Compared with pTNM, cTNM survival was “pinched,” with poorer survival for early cStage groups and better survival for advanced ones. Histologic grade was distinctive for data-driven grouping of cT2N0M0 squamous cell carcinoma (SCC) and cT1-2N0M0 adenocarcinoma, but consensus removed it. Grouping was different by histopathologic cell type. For SCC, cN0-1 was distinctive for cT3 but not cT1-2, and consensus removed cT4 subclassification and added subgroups 0, IVA, and IVB. For adenocarcinoma, N0-1 was distinctive for cT1-2 but not cT3-4a, cStage II subgrouping was necessary (T1N1M0 [IIA] and T2N0M0 [IIB]), advanced cancers cT3-4aN0-1M0 plus cT2N1M0 comprised cStage III, and consensus added subgroups 0, IVA, and IVB. Treatment decisions require accurate cStage, which differs from pStage. Understaging and overstaging are problematic, and additional factors, such as grade, may facilitate treatment decisions and prognostication until clinical staging techniques are uniformly applied and improved. PMID:27905171

Efficacy and toxicity profiles of two chemoradiotherapies for stage II laryngeal cancer - a comparison between late course accelerated hyperfractionation (LCAHF) and conventional fractionation (CF).

PubMed

Okazaki, Eiichiro; Matsushita, Naoki; Tashiro, Mari; Shimatani, Yasuhiko; Ishii, Kentaro; Hosono, Masako; Oishi, Masahiro; Teranishi, Yuichi; Iguchi, Hiroyoshi; Miki, Yukio

2017-08-01

To evaluate the treatment results of late course accelerated hyperfractionation (LCAHF) compared with conventional fractionation (CF) for stage II laryngeal cancer. Fifty-nine consecutive patients treated for stage II laryngeal cancer were retrospectively reviewed. Thirty-two patients underwent LCAHF, twice-daily fractions during the latter half with a total dose of 69 Gy. Twenty-seven patients received CF of 70 Gy. The local control rates (LCRs), overall survival (OS), and disease-specific survival (DSS) at 5 years were 80.6%, 74.0%, and 90.4%, respectively, after LCAHF and 64.7%, 68.2%, and 90.5%, respectively, after CF. There were no significant differences in LCR, OS, and DSS (p = .11, 0.68, and 0.69, respectively). In a small number of patients with supraglottic cancer, LCAHF was associated with a significantly higher LCR at 5 years compared with CF (100% vs. 41.7%; p = .02). This is the first report that compared the results of LCAHF and CF for stage II laryngeal cancer. We could not find significant differences in LCR, DSS, and OS rates between LCAHF and CF groups. Although in a small number of patients with supraglottic cancer, LCAHF may improve the LCR compared with CF.

Development of an innovative sandwich common bulkhead for cryogenic upper stage propellant tank

NASA Astrophysics Data System (ADS)

Szelinski, B.; Lange, H.; Röttger, C.; Sacher, H.; Weiland, S.; Zell, D.

2012-12-01

In the frame of the Future Launcher Preparatory Program (FLPP) investigating advancing technologies for the Next Generation of Launchers (NGL) a number of novel key technologies are presently under development for significantly improving vehicle performance in terms of payload capacity and mission versatility. As a respective ESA guided technology development program, Cryogenic Upper Stage Technologies (CUST) has been launched within FLPP that hosts among others the development of a common bulkhead to separate liquid hydrogen from the liquid oxygen compartment. In this context, MT Aerospace proposed an advanced sandwich design concept which is currently in the development phase reaching for TRL4 under MT Aerospace responsibility. Key components of this sandwich common bulkhead are a specific core material, situated in-between two thin aluminum face sheets, and an innovative thermal decoupling element at the equatorial region. The combination of these elements provides excellent thermal insulation capabilities and mechanical performance at a minimum weight, since mechanical and thermal functions are merged in the same component. This improvement is expressed by substantial performance figures of the proposed concept that include high resistance against reverse pressure, an optimized heat leak and minimized mass, involving the sandwich dome structure and the adjacent interface rings. The development of single sub-technologies, all contributing to maturate the sandwich common bulkhead towards the desired technology readiness level (TRL), is described in the context of the given design constraints as well as technical, functional and programmatic requirements, issued from the stage level. This includes the thermal and mechanical characterization of core materials, manufacturing issues as well as non-destructive testing and the thermal and structural analyses and dimensioning of the complete common bulkhead system. Dedicated TRL assessments in the Ariane 5 Mid

A retrospective study using the pressure ulcer scale for healing (PUSH) tool to examine factors affecting stage II pressure ulcer healing in a Korean acute care hospital.

PubMed

Park, Kyung Hee

2014-09-01

Stage II pressure ulcers (PUs) should be managed promptly and appropriately in order to prevent complications. To identify the factors affecting Stage II PU healing and optimize care, the electronic medical records of patients with a Stage II PU in an acute care hospital were examined. Patient and ulcer characteristics as well as nutritional assessment variables were retrieved, and ulcer variables were used to calculate Pressure Ulcer Scale for Healing (PUSH) scores. The effect of all variables on healing status (healed versus nonhealed) and change in PUSH score for healing rate were compared. Records of 309 Stage II PUs from 155 patients (mean age 61.2 ± 15.2 [range 5-89] years, 182 [58.9%] male) were retrieved and analyzed. Of those, 221 healed and 88 were documented as not healed at the end of the study. The variables that were significantly different between patients with PUs that did and did not heal were: major diagnosis (P = 0.001), peripheral arterial disease (P = 0.007), smoking (P = 0.048), serum albumin ( <2.5 g/dL) (P = 0.002), antidepressant use (P = 0.035), vitamin use (P = 0.006), history of surgery (P <0.001), PU size (P = 0.003), Malnutrition Universal Screening Tool (MUST) score (P = 0.020), Braden scale score (P = 0.003), and mean arterial pressure (MAP, mm Hg) (P = 0.026). The Cox proportional hazard model showed a significant positive difference in PUSH score change -indicative of healing - when pressure-redistribution surfaces were used (P <0.001, HR = 2.317), PU size was small (≤3.0 cm2, P = 0.006, HR = 1.670), MAP (within a range of 52-112 mm Hg) was higher P = 0.010, HR = 1.016), and patients were provided multivitamins (P = 0.037, HR=1.431). The results of this study suggest strategies for healing Stage II PUs in the acute care setting should include early recognition of lower-stage PUs, the provision of static pressure-redistribution surfaces and multivitamins, and maintaining higher MAP may facilitate healing and prevent deterioration

Functional studies in 79-year-olds. II. Upper extremity function.

PubMed

Lundgren-Lindquist, B; Sperling, L

1983-01-01

As part of the Gerontological and Geriatric Population Study of 79-year-old people in Göteborg, a representative subsample comprising 112 women and 93 men took part in a study of upper extremity function. Thirty-eight per cent of the women and 37% of the men had disorders in the upper extremities. The investigation included tests of co-ordination, static strength in the key-grip and the transversal volar grip, power capacity in opening jars and a bottle, basal movements in the upper extremities in personal hygiene and dressing activities, function in the kitchen e.g. reaching shelves, manual tasks including tests of pronation and supination of the forearm. In the key-grip as well as in the transversal volar grip men showed a generally larger decrease in strength with age than women compared to 70-year-olds in a previous population study. Significant correlations were found between strength in the key-grip and the performance time in the test of co-ordination. Women produced about 66% of the muscular force of the men when opening jars. Significant correlations were found between strength in the transversal volar grip and the maximal torque for opening the jars. Female and male subjects who were not capable of handling the electric plug in the manual ability test had significantly weaker strength in the key-grip. The importance of designing products and adapting the environment so as to correspond to the functional capacity of the elderly, is emphasized.

Ares I Upper Stage Pressure Tests in Wind Tunnel

NASA Technical Reports Server (NTRS)

2007-01-01

Under the goals of the Vision for Space Exploration, Ares I is a chief component of the cost-effective space transportation infrastructure being developed by NASA's Constellation Program. This transportation system will safely and reliably carry human explorers back to the moon, and then onward to Mars and other destinations in the solar system. The Ares I effort includes multiple project element teams at NASA centers and contract organizations around the nation, and is managed by the Exploration Launch Projects Office at NASA's Marshall Space Flight Center (MFSC). ATK Launch Systems near Brigham City, Utah, is the prime contractor for the first stage booster. ATK's subcontractor, United Space Alliance of Houston, is designing, developing and testing the parachutes at its facilities at NASA's Kennedy Space Center in Florida. NASA's Johnson Space Center in Houston hosts the Constellation Program and Orion Crew Capsule Project Office and provides test instrumentation and support personnel. Together, these teams are developing vehicle hardware, evolving proven technologies, and testing components and systems. Their work builds on powerful, reliable space shuttle propulsion elements and nearly a half-century of NASA space flight experience and technological advances. Ares I is an inline, two-stage rocket configuration topped by the Crew Exploration Vehicle, its service module, and a launch abort system. In this HD video image, the first stage reentry 1/2% model is undergoing pressure measurements inside the wind tunnel testing facility at MSFC. (Highest resolution available)

Macroscopic appearance of Type IV and giant Type III is a high risk for a poor prognosis in pathological stage II/III advanced gastric cancer with postoperative adjuvant chemotherapy

PubMed Central

Yamashita, Keishi; Ema, Akira; Hosoda, Kei; Mieno, Hiroaki; Moriya, Hiromitsu; Katada, Natsuya; Watanabe, Masahiko

2017-01-01

AIM To evaluate whether a high risk macroscopic appearance (Type IV and giant Type III) is associated with a dismal prognosis after curative surgery, because its prognostic relevance remains elusive in pathological stage II/III (pStage II/III) gastric cancer. METHODS One hundred and seventy-two advanced gastric cancer (defined as pT2 or beyond) patients with pStage II/III who underwent curative surgery plus adjuvant S1 chemotherapy were evaluated, and the prognostic relevance of a high-risk macroscopic appearance was examined. RESULTS Advanced gastric cancers with a high-risk macroscopic appearance were retrospectively identified by preoperative recorded images. A high-risk macroscopic appearance showed a significantly worse relapse free survival (RFS) (35.7%) and overall survival (OS) (34%) than an average risk appearance (P = 0.0003 and P < 0.0001, respectively). A high-risk macroscopic appearance was significantly associated with the 13th Japanese Gastric Cancer Association (JGCA) pT (P = 0.01), but not with the 13th JGCA pN. On univariate analysis for RFS and OS, prognostic factors included 13th JGCA pStage (P < 0.0001) and other clinicopathological factors including macroscopic appearance. A multivariate Cox proportional hazards model for univariate prognostic factors identified high-risk macroscopic appearance (P = 0.036, HR = 2.29 for RFS and P = 0.021, HR = 2.74 for OS) as an independent prognostic indicator. CONCLUSION A high-risk macroscopic appearance was associated with a poor prognosis, and it could be a prognostic factor independent of 13th JGCA stage in pStage II/III advanced gastric cancer. PMID:28451064

Impact of Pre-Stage II Hemodynamics and Pulmonary Artery Anatomy on 12-Month Outcome in the Single Ventricle Reconstruction Trial

PubMed Central

Aiyagari, Ranjit; Rhodes, John F.; Shrader, Peter; Radtke, Wolfgang A.; Bandisode, Varsha M.; Bergersen, Lisa; Gillespie, Matthew J.; Gray, Robert G.; Guey, Lin T.; Hill, Kevin D.; Hirsch, Russel; Kim, Dennis W.; Lee, Kyong-Jin; Pelech, Andrew N.; Ringewald, Jeremy; Takao, Cheryl; Vincent, Julie A.; Ohye, Richard G.

2014-01-01

Objective To compare interstage cardiac catheterization hemodynamic and angiographic findings between shunt types for Single Ventricle Reconstruction (SVR) trial. Background The SVR trial, which randomized subjects to modified Blalock-Taussig shunt (MBTS) or right ventricle-to-pulmonary artery shunt (RVPAS) for the Norwood procedure, demonstrated RVPAS was associated with smaller pulmonary artery diameter, but superior 12-month transplant-free survival. Methods We analyzed pre-stage II catheterization data for SVR trial subjects. Hemodynamic variables and shunt and pulmonary angiography were compared between shunt types; their association with 12-month transplant-free survival was also evaluated. Results Of 549 randomized subjects, 389 underwent pre-stage II catheterization. Smaller size, lower aortic and superior vena cava saturation, and higher ventricular end-diastolic pressure (EDP) were associated with worse 12-month transplant-free survival. MBTS subjects had lower coronary perfusion pressure (27mmHg vs. 32mmHg, P<0.001) and higher Qp:Qs ratio (1.1 vs. 1.0, P=0.009). Higher Qp:Qs ratio increased the risk of death or transplant only in the RVPAS group (P=0.01). MBTS subjects had fewer shunt (14% vs. 28%, P=0.004) and severe left pulmonary artery stenoses (0.7% vs. 9.2%, P=0.003), larger mid-main branch pulmonary artery diameters and higher Nakata index (164 vs. 134, P<0.001). Conclusions Compared with RVPAS subjects, MBTS subjects had more hemodynamic abnormalities related to shunt physiology, while RVPAS subjects had more shunt or pulmonary obstruction of a severe degree, and inferior pulmonary artery growth at pre-stage II catheterization. Lower BSA, higher ventricular EDP, and lower SVC saturation were associated with worse 12-month transplant-free survival. PMID:24332668

High-dose versus standard-dose radiotherapy with concurrent chemotherapy in stages II-III esophageal cancer.

PubMed

Suh, Yang-Gun; Lee, Ik Jae; Koom, Wong Sub; Cha, Jihye; Lee, Jong Young; Kim, Soo Kon; Lee, Chang Geol

2014-06-01

In this study, we investigated the effects of radiotherapy ≥60 Gy in the setting of concurrent chemo-radiotherapy for treating patients with Stages II-III esophageal cancer. A total of 126 patients treated with 5-fluorouracilbased concurrent chemo-radiotherapy between January 1998 and February 2008 were retrospectively reviewed. Among these patients, 49 received a total radiation dose of <60 Gy (standard-dose group), while 77 received a total radiation dose of ≥60 Gy (high-dose group). The median doses in the standard- and high-dose groups were 54 Gy (range, 45-59.4 Gy) and 63 Gy (range, 60-81 Gy), respectively. The high-dose group showed significantly improved locoregional control (2-year locoregional control rate, 69 versus 32%, P < 0.01) and progression-free survival (2-year progression-free survival, 47 versus 20%, P = 0.01) than the standard-dose group. Median overall survival in the high- and the standard-dose groups was 28 and 18 months, respectively (P = 0.26). In multivariate analysis, 60 Gy or higher radiotherapy was a significant prognostic factor for improved locoregional control, progression-free survival and overall survival. No significant differences were found in frequencies of late radiation pneumonitis, post-treatment esophageal stricture or treatment-related mortality between the two groups. High-dose radiotherapy of 60 Gy or higher with concurrent chemotherapy improved locoregional control and progression-free survival without a significant increase of in treatment-related toxicity in patients with Stages II-III esophageal cancer. Our study could provide the basis for future randomized clinical trials. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Global water vapor distributions in the stratosphere and upper troposphere derived from 5.5 years of SAGE II observations (1986-1991)

NASA Astrophysics Data System (ADS)

Chiou, E. W.; McCormick, M. P.; Chu, W. P.

1997-08-01

Global distributions of water vapor in the stratosphere and upper troposphere are presented on the basis of ˜5.5 years (January 1986 to May 1991) of observations from the Stratospheric Aerosol and Gas Experiment II (SAGE II) aboard the Earth Radiation Budget Satellite (ERBS). Tabulations are included for seasonal zonal mean water vapor mixing ratios (in parts per million by volume) with 1-km vertical resolution and an altitude range from 6 to 40 km. Several climatological features identified in a previous study [McCormick et al., 1993], based on 3 years of observations, have been confirmed by this study: (1) the existence of a region of minimum water vapor (the hygropause) at all latitude bands; (2) the increase in the distance between the tropopause and the hygropause from 1 km at low latitudes to 4 km at high latitudes; and (3) the appearance of a positive poleward gradient throughout all seasons for fixed altitudes between 20 km and 40 km. The latitudinal variation of water vapor mixing ratio at 20 km is characterized by a symmetric pattern with a minimum occurring at the equator. However, the corresponding variations at 25 and 30 km indicate a shift of the minimum toward the summer hemisphere. For the latitude zones 0°-20° and 20°-40° in both hemispheres, the seasonal variations of the hygropause reveal that the altitude as well as the value of the minimum water vapor mixing ratio remain essentially unchanged from December, January, and February to March, April, and May. During September, October, and November the weakening of the hygropause and the spreading of the region of minimum water vapor to a wider altitude range are identified throughout these low-latitude and midlatitude zones. For the upper troposphere the clear-sky relative humidities at 300 mbar show a typical range of 5-60%, which is consistent with previous findings based on Meteosat 6.3 μm measurements. In addition, the unique capability of SAGE II observations has provided us with

Transoral Robotic Surgery in Treating Patients With Benign or Stage I-IV Head and Neck Cancer

ClinicalTrials.gov

2014-11-07

Recurrent Adenoid Cystic Carcinoma of the Oral Cavity; Recurrent Lymphoepithelioma of the Nasopharynx; Recurrent Lymphoepithelioma of the Oropharynx; Recurrent Mucoepidermoid Carcinoma of the Oral Cavity; Recurrent Squamous Cell Carcinoma of the Hypopharynx; Recurrent Squamous Cell Carcinoma of the Larynx; Recurrent Squamous Cell Carcinoma of the Lip and Oral Cavity; Recurrent Squamous Cell Carcinoma of the Nasopharynx; Recurrent Squamous Cell Carcinoma of the Oropharynx; Recurrent Verrucous Carcinoma of the Larynx; Recurrent Verrucous Carcinoma of the Oral Cavity; Stage I Adenoid Cystic Carcinoma of the Oral Cavity; Stage I Lymphoepithelioma of the Nasopharynx; Stage I Lymphoepithelioma of the Oropharynx; Stage I Mucoepidermoid Carcinoma of the Oral Cavity; Stage I Squamous Cell Carcinoma of the Hypopharynx; Stage I Squamous Cell Carcinoma of the Larynx; Stage I Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage I Squamous Cell Carcinoma of the Nasopharynx; Stage I Squamous Cell Carcinoma of the Oropharynx; Stage I Verrucous Carcinoma of the Larynx; Stage I Verrucous Carcinoma of the Oral Cavity; Stage II Adenoid Cystic Carcinoma of the Oral Cavity; Stage II Lymphoepithelioma of the Nasopharynx; Stage II Lymphoepithelioma of the Oropharynx; Stage II Mucoepidermoid Carcinoma of the Oral Cavity; Stage II Squamous Cell Carcinoma of the Hypopharynx; Stage II Squamous Cell Carcinoma of the Larynx; Stage II Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage II Squamous Cell Carcinoma of the Nasopharynx; Stage II Squamous Cell Carcinoma of the Oropharynx; Stage II Verrucous Carcinoma of the Larynx; Stage II Verrucous Carcinoma of the Oral Cavity; Stage III Adenoid Cystic Carcinoma of the Oral Cavity; Stage III Lymphoepithelioma of the Nasopharynx; Stage III Lymphoepithelioma of the Oropharynx; Stage III Mucoepidermoid Carcinoma of the Oral Cavity; Stage III Squamous Cell Carcinoma of the Hypopharynx; Stage III Squamous Cell Carcinoma of the Larynx; Stage

Mucinous Adenocarcinomas Histotype Can Also be a High-Risk Factor for Stage II Colorectal Cancer Patients.

PubMed

Hu, Xiang; Li, Ya-Qi; Li, Qing-Guo; Ma, Yan-Lei; Peng, Jun-Jie; Cai, Sanjun

2018-05-22

Colorectal mucinous adenocarcinoma (MA) has been associated with a worse prognosis than adenocarcinoma (AD) in advanced stages. Little is known about the prognostic impact of a mucinous histotype on the early stages of colorectal cancer with negative lymph node (LN) metastasis. In contrast to the established prognostic factors such as T stage and grading, the histological subtype is not thought to contribute to the therapeutic outcome, although different subtypes can potentially represent different entities. In this study, we aimed to define the prognostic value of mucinous histology in colorectal cancer with negative LNs. Between 2006 and 2017, a total of 4893 consecutive patients without LN metastasis underwent radical surgery for primary colorectal cancer (MA and AD) in Fudan University Shanghai Cancer Center (FUSCC). Clinical, histopathological, and survival data were analyzed. The incidence of MA was 11% in 4893 colorectal cancer patients without LN metastasis. The MA patients had a higher T category, a greater percentage of LN harvested, larger tumor size and worse grading than the AD patients (p < 0.001 for each). We found that MA histology was correlated with a poor prognosis in terms of relapse in node-negative patients, and MA histology combined with TNM staging may be a feasible method for predicting the relapse rate. Additionally, MA presented as a high-risk factor in patients with negative perineural or vascular invasion and well/moderate-differentiation and showed a more dismal prognosis for stage II patients. Meanwhile, the disease-free survival was identical in MA and AD patients after neo- and adjuvant chemotherapy. MA histology is an independent predictor of poor prognosis due to relapse in LN-negative colorectal cancer patients. Mucinous histology can suggest a possible high risk in early-stage colorectal carcinoma. © 2018 The Author(s). Published by S. Karger AG, Basel.

Isolation and characterization of the stage-specific cytochrome b small subunit (CybS) of Ascaris suum complex II from the aerobic respiratory chain of larval mitochondria.

PubMed

Amino, Hisako; Osanai, Arihiro; Miyadera, Hiroko; Shinjyo, Noriko; Tomitsuka, Eriko; Taka, Hikari; Mineki, Reiko; Murayama, Kimie; Takamiya, Shinzaburo; Aoki, Takashi; Miyoshi, Hideto; Sakamoto, Kimitoshi; Kojima, Somei; Kita, Kiyoshi

2003-05-01

We recently reported that Ascaris suum mitochondria express stage-specific isoforms of complex II: the flavoprotein subunit and the small subunit of cytochrome b (CybS) of the larval complex II differ from those of adult enzyme, while two complex IIs share a common iron-sulfur cluster subunit (Ip). In the present study, A. suum larval complex II was highly purified to characterize the larval cytochrome b subunits in more detail. Peptide mass fingerprinting and N-terminal amino acid sequencing showed that the larval and adult cytochrome b (CybL) proteins are identical. In contrast, cDNA sequences revealed that the small subunit of larval cytochrome b (CybS(L)) is distinct from the adult CybS (CybS(A)). Furthermore, Northern analysis and immunoblotting showed stage-specific expression of CybS(L) and CybS(A) in larval and adult mitochondria, respectively. Enzymatic assays revealed that the ratio of rhodoquinol-fumarate reductase (RQFR) to succinate-ubiquinone reductase (SQR) activities and the K(m) values for quinones are almost identical for the adult and larval complex IIs, but that the fumarate reductase (FRD) activity is higher for the adult form than for the larval form. These results indicate that the adult and larval A. suum complex IIs have different properties than the complex II of the mammalian host and that the larval complex II is able to function as a RQFR. Such RQFR activity of the larval complex II would be essential for rapid adaptation to the dramatic change of oxygen availability during infection of the host.

A mechanism for upper airway stability during slow wave sleep.

PubMed

McSharry, David G; Saboisky, Julian P; Deyoung, Pam; Matteis, Paul; Jordan, Amy S; Trinder, John; Smales, Erik; Hess, Lauren; Guo, Mengshuang; Malhotra, Atul

2013-04-01

The severity of obstructive sleep apnea is diminished (sometimes markedly) during slow wave sleep (SWS). We sought to understand why SWS stabilizes the upper airway. Increased single motor unit (SMU) activity of the major upper airway dilating muscle (genioglossus) should improve upper airway stability. Therefore, we hypothesized that genioglossus SMUs would increase their activity during SWS in comparison with Stage N2 sleep. The activity of genioglossus SMUs was studied on both sides of the transition between Stage N2 sleep and SWS. Sleep laboratory. Twenty-nine subjects (age 38 ± 13 yr, 17 males) were studied. SWS. Subjects slept overnight with fine-wire electrodes in their genioglossus muscles and with full polysomnographic and end tidal carbon dioxide monitors. Fifteen inspiratory phasic (IP) and 11 inspiratory tonic (IT) units were identified from seven subjects and these units exhibited significantly increased inspiratory discharge frequencies during SWS compared with Stage N2 sleep. The peak discharge frequency of the inspiratory units (IP and IT) was 22.7 ± 4.1 Hz in SWS versus 20.3 ± 4.5 Hz in Stage N2 (P < 0.001). The IP units also fired for a longer duration (expressed as a percentage of inspiratory time) during SWS (104.6 ± 39.5 %TI) versus Stage N2 sleep (82.6 ± 39.5 %TI, P < 0.001). The IT units fired faster during expiration in SWS (14.2 ± 1.8 Hz) versus Stage N2 sleep (12.6 ± 3.1 Hz, P = 0.035). There was minimal recruitment or derecruitment of units between SWS and Stage N2 sleep. Increased genioglossus SMU activity likely makes the airway more stable and resistant to collapse throughout the respiratory cycle during SWS.

VAC protocol for treatment of dogs with stage III hemangiosarcoma.

PubMed

Alvarez, Francisco J; Hosoya, Kenji; Lara-Garcia, Ana; Kisseberth, William; Couto, Guillermo

2013-01-01

Hemangiosarcomas (HSAs) are aggressive tumors with a high rate of metastasis. Clinical stage has been considered a negative prognostic factor for survival. The study authors hypothesized that the median survival time (MST) of dogs with metastatic (stage III) HSA treated with a vincristine, doxorubicin, and cyclophosphamide (VAC) chemotherapy protocol would not be different than those with stage I/II HSA. Sixty-seven dogs with HSA in different anatomic locations were evaluated retrospectively. All dogs received the VAC protocol as an adjuvant to surgery (n = 50), neoadjuvant (n = 3), or as the sole treatment modality (n = 14). There was no significant difference (P = 0.97) between the MST of dogs with stage III and stage I/II HSA. For dogs presenting with splenic HSA alone, there was no significant difference between the MST of dogs with stage III and stage I/II disease (P = 0.12). The overall response rate (complete response [CR] and partial response [PR]) was 86%). No unacceptable toxicities were observed. Dogs with stage III HSA treated with the VAC protocol have a similar prognosis to dogs with stage I/II HSA. Dogs with HSA and evidence of metastases at the time of diagnosis should not be denied treatment.

Single-Stage Resection of Type II Constriction Rings in Limbs on the Basis of Histologic and Magnetic Resonance Imaging Observations: A Retrospective Study of 21 Consecutive Patients.

PubMed

Jiang, Yongkang; Mao, Hailei; Yang, Xi; Zhou, Shengbo; Ni, Feng; Xu, Qiming; Wang, Bin

2016-07-01

The purpose of this study was to determine the feasibility of single-stage resection for type II congenital constriction rings by means of histologic examination of resected specimens and imaging examination of affected extremities, and to evaluate the appearance and function of the extremities after single-stage surgery. The features of the skin on the constriction rings and the subcutaneous tissues were identified through continuous sectioning, hematoxylin and eosin staining, and immunohistologic staining of specimens of type II constriction rings obtained by means of surgery. The relationship between the constriction rings and the deep main blood vessels was evaluated using magnetic resonance imaging. Single-stage resection of the constriction band, reduction of the fascial flap, and triangular flap-plasty were performed for 21 patients. The appearance, lymphedema, and movement of the extremities were compared before and after the operation. Type II constriction rings in the extremities had normal full-layer skin structures. Collagen was found deposited densely at the base of the grooves, but the normal subcutaneous tissue space remained, and the vital nerves and blood vessels were unaffected. Complete resection of the constriction rings was achieved in all 21 patients, and lymphedema subsided 2 months after the operation. No episode of recurrence was found, and limb function was not affected at 26-month follow-up. Type II congenital constriction rings in limbs possess normal subcutaneous tissue spaces. A single-stage operation, which includes complete resection of the rings, fascial flap reduction, and triangular flap-plasty, could achieve a satisfactory appearance and good function. Therapeutic, III.

Five-year disease-free survival among stage II-IV breast cancer patients receiving FAC and AC chemotherapy in phase II clinical trials of Panagen.

PubMed

Proskurina, Anastasia S; Gvozdeva, Tatiana S; Potter, Ekaterina A; Dolgova, Evgenia V; Orishchenko, Konstantin E; Nikolin, Valeriy P; Popova, Nelly A; Sidorov, Sergey V; Chernykh, Elena R; Ostanin, Alexandr A; Leplina, Olga Y; Dvornichenko, Victoria V; Ponomarenko, Dmitriy M; Soldatova, Galina S; Varaksin, Nikolay A; Ryabicheva, Tatiana G; Uchakin, Peter N; Rogachev, Vladimir A; Shurdov, Mikhail A; Bogachev, Sergey S

2016-08-18

We report on the results of a phase II clinical trial of Panagen (tablet form of fragmented human DNA preparation) in breast cancer patients (placebo group n = 23, Panagen n = 57). Panagen was administered as an adjuvant leukoprotective agent in FAC and AC chemotherapy regimens. Pre-clinical studies clearly indicate that Panagen acts by activating dendritic cells and induces the development of adaptive anticancer immune response. We analyzed 5-year disease-free survival of patients recruited into the trial. Five-year disease-free survival in the placebo group was 40 % (n = 15), compared with the Panagen arm - 53 % (n = 51). Among stage III patients, disease-free survival was 25 and 52 % for placebo (n = 8) and Panagen (n = 25) groups, respectively. Disease-free survival of patients with IIIB + C stage was as follows: placebo (n = 6)-17 % vs Panagen (n = 18)-50 %. Disease-free survival rate (17 %) of patients with IIIB + C stage breast cancer receiving standard of care therapy is within the global range. Patients who additionally received Panagen demonstrate a significantly improved disease-free survival rate of 50 %. This confirms anticancer activity of Panagen. ClinicalTrials.gov NCT02115984 from 04/07/2014.

Dose-Response Relationship between Radiation Dose and Loco-regional Control in Patients with Stage II-III Esophageal Cancer Treated with Definitive Chemoradiotherapy.

PubMed

Kim, Hyun Ju; Suh, Yang-Gun; Lee, Yong Chan; Lee, Sang Kil; Shin, Sung Kwan; Cho, Byung Chul; Lee, Chang Geol

2017-07-01

The correlation between radiation dose and loco-regional control (LRC) was evaluated in patients with stage II-III esophageal cancer treated with definitive concurrent chemoradiotherapy (CRT). Medical records of 236 stage II-III esophageal cancer patients treated with definitive CRT at Yonsei Cancer Center between 1994 and 2013 were retrospectively reviewed. Among these, 120 received a radiation dose of < 60 Gy (standard-dose group), while 116 received ≥ 60 Gy (high-dose group). The median doses of radiation in the standard- and high-dose groups were 50.4 and 63 Gy, respectively. Concurrent 5-fluorouracil/cisplatin chemotherapy was administered to most patients. There were no differences in patient characteristics between the two groups except for high Karnofsky performance status and lower-thoracic lesions being more prevalent in the standard-dose group. The median progression-free survival (PFS) and overall survival (OS) times were 13.2 months and 26.2 months, respectively. Patients in the high-dose group had significantly better 2-year LRC (69.1% vs. 50.3%, p=0.002), median PFS (16.7 months vs. 11.7 months, p=0.029), and median OS (35.1 months vs. 22.3 months, p=0.043). Additionally, LRC exhibited a dose-response relationship and the complete response rate was significantly higher in the high-dose group (p=0.006). There were no significant differences in treatment-related toxicities between the groups. A higher radiation dose (> 60 Gy) is associated with increased LRC, PFS, and OS in patients with stage II-III esophageal cancer treated with definitive CRT.

Declining Use of Radiotherapy in Stage I and II Hodgkin's Disease and Its Effect on Survival and Secondary Malignancies

DOE Office of Scientific and Technical Information (OSTI.GOV)

Koshy, Matthew, E-mail: mkoshy@radonc.uchicago.edu; Department of Radiation Oncology, University of Illinois at Chicago, Chicago, IL; Rich, Shayna E.

2012-02-01

Purpose: Concerns regarding long-term toxicities have led some to withhold radiotherapy (RT) for the treatment of Stage I and II Hodgkin's disease (HD). The present study was undertaken to assess the use of RT for HD and its effect on overall survival and the development of secondary malignancies. Methods and Materials: The present study included data from the Surveillance, Epidemiology, and End Results database from patients aged {>=}20 years who had been diagnosed with Stage I or II HD between 1988 and 2006. Overall survival was estimated using the Kaplan-Meier method, and the Cox multivariate regression model was used tomore » analyze trends. Results: A total of 12,247 patients were selected, and 51.5% had received RT. The median follow-up for the present cohort was 4.9 years, with 21% of the cohort having >10 years of follow-up. Between 1988 and 1991, 62.9% had undergone RT, but between 2004 and 2006, only 43.7% had undergone RT (p < .001). The 5-year overall survival rate was 76% for patients who had not received RT and 87% for those who had (p < .001). The hazard ratio adjusted for other variables in the regression model showed that patients who had not undergone RT (hazard ratio, 1.72; 95% confidence interval, 1.72-2.02) was associated with significantly worse survival compared with patients who had received RT. The actuarial rate of developing a second malignancy was 14.6% vs. 15.0% at 15 years for those who had and had not undergone RT, respectively (p = .089). Conclusions: The present study is one of the largest studies to examine the role of RT for Stage I and II HD. Our results revealed a survival benefit with the addition of RT with no increase in the development of secondary malignancies compared with patients who had not received RT. Furthermore, the present nationwide study revealed a >20% absolute decrease in the use of RT from 1988 to 2006.« less

Performance of 15-Stage Experimental J71 Axial-Flow Compressor: II - Individual Stage Performance Characteristics

NASA Technical Reports Server (NTRS)

Lucas, James G.; Filippi, Richard E.

1954-01-01

The first four stages were found to cause a major part of the poor low-speed efficiency of this compressor. The low design-speed over-all pressure ratio at surge was caused by the first and the twelfth to fifteenth stages. The multiple over-all performance curves in the intermediate-speed range were at least partly the result of double-branched characteristic curves for the third and seventh stages.

Management Trends and Outcomes for Stage I to II Mantle Cell Lymphoma Using the National Cancer Data Base: Ascertaining the Ideal Treatment Paradigm

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gill, Beant S.; Vargo, John A.; Pai, Sarah S.

Purpose: Mantle cell lymphoma (MCL) is a rare, albeit aggressive subset of non-Hodgkin lymphoma, resulting in varied treatment approaches. Given the paucity of data defining the optimal management for early-stage MCL, we conducted an analysis using the National Cancer Data Base (NCDB) to identify practice patterns and outcomes. Methods and Materials: The NCDB was queried for patients with stage I to II MCL diagnosed from 1998 to 2012 receiving chemotherapy (CT) or radiation therapy (RT), or both (CT+RT). Univariate and multivariable analyses for factors associated with treatment selection were completed using logistic regression. Propensity scores with inverse probability treatment weightingmore » (IPTW) were calculated based on the conditional probability of receiving CT+RT. The log-rank test and Cox proportional hazards modeling with IPTW adjustment were conducted for the survival analyses. Results: In total, 2539 patients were identified. The key characteristics were as follows: 69% were male, 71% were aged ≥60 years, 28% had extranodal involvement, and 51% had stage I disease. Of the 2539 patients, 70% underwent CT, 11% underwent RT, and 19% underwent CT+RT. The use of CT+RT decreased from 23.1% to 14.1% in 1998 to 2002 and 2010 to 2012 (P<.001). CT+RT usage was lower for patients with the following characteristics: age ≥60 years, female sex, stage II disease, and the presence of B symptoms. With a median follow-up period of 42.8 months, the unadjusted 3-year overall survival estimates for patients receiving CT, RT, or CT+RT were 67.8%, 72.4%, and 79.8%, respectively (P<.001). After correcting for indication bias through IPTW-adjusted modeling, CT+RT reduced the risk of overall mortality compared with monotherapy (hazard ratio 0.65, P=.029). Conclusions: Although uncommon, patients with stage I-II MCL can have favorable outcomes. Despite a continued decline in the usage of consolidative RT, combined modality therapy improves survival in this cohort

The comparison of frequency of the upper limb musculoskeletal disorders among patients with diabetes type II with normal cases.

PubMed

Kermani, Zahra Haeri; Bazzaz, Seyed Mojtaba Mousavi; Farahmand, Seyed Kazem; Raoof, Ali Akbar

2017-11-01

Musculoskeletal disease, that is recognized in diabetes and diabetes mellitus (DM) has shown a higher prevalence of chronic musculoskeletal complications. This study aimed at assessing the frequency of upper limb musculoskeletal disorders among patients with diabetes type II with normal cases in Mashhad, Iran. A cross-section of 100 patients with upper limb musculoskeletal disorders were enrolled in this study. The patients were examined by a unique physician considering carpal tunnel syndrome disorder, trigger finger, adhesive capsulitis, and Dupuytren's contracture at Ghaem hospital, Mashhad, Iran in 2015. All collected data were recorded by using SPSS version 21 and were analyzed through independent-samples t-test for comparing changes, and Chi-square. In this study, the mean age was 51.7±8.7 years old. Gender frequency was 114 (57%) male, and 86 (43%) female. There was no significant difference between groups in cases of gender frequency and mean of age (p>0.05). In evaluation of association between the two groups, there was significant difference for adhesive capsulitis, (p=0.04). Chi-square test showed significant association for age and adhesive capsulitis between the two groups, (p=0.040); but no other diabetes-related disorders, (p<0.05). The results of this study showed that in patients with diabetes mellitus and musculoskeletal complications such as upper limb musculoskeletal abnormalities, it will lead to an increase in skeletal muscle effects in DM patients. It is recommended that musculoskeletal examination is done periodically in DM patients for identification of these disorders and necessary actions are carried out for prevention of the disorders as soon as possible.

Demographics and Outcomes of Stage I-II Merkel Cell Carcinoma Treated with Mohs Micrographic Surgery Compared with Wide Local Excision in the National Cancer Data Base.

PubMed

Singh, Babu; Qureshi, Muhammad M; Truong, Minh Tam; Sahni, Debjani

2018-02-03

The optimal surgical approach (wide local excision (WLE) vs. Mohs micrographic surgery (MOHS)) for treating Merkel cell carcinoma (MCC) is yet to be determined. To compare survival outcomes in patients with early stage MCC treated with MOHS versus WLE. A retrospective review of all cases in the National Cancer Data Base (NCDB) of MCC of clinical Stage I-II MCC treated with WLE or MOHS was performed. 1,795 cases of Stage I-II MCC were identified who underwent WLE (N=1,685) or MOHS (N=110). There was no difference in residual tumor on surgical margins between the two treatment groups (p=0.588). On multivariate analysis, there was no difference in overall survival between the treatment modalities (adjusted HR 1.02; 95% CI 0.72-1.45, p=0.897). There was no difference in overall survival between the two groups on propensity score matched analysis. Disease specific survival was not reported as this data in not available in the NCDB. MOHS appears to be as effective as WLE in treating early stage MCC. Copyright © 2018. Published by Elsevier Inc.

Recommendations for neoadjuvant pathologic staging (ypTNM) of cancer of the esophagus and esophagogastric junction for the 8th edition AJCC/UICC staging manuals.

PubMed

Rice, Thomas W; Ishwaran, Hemant; Kelsen, David P; Hofstetter, Wayne L; Apperson-Hansen, Carolyn; Blackstone, Eugene H

2016-11-01

We report analytic and consensus processes that produced recommendations for neoadjuvant pathologic stage groups (ypTNM) of esophageal and esophagogastric junction cancer for the AJCC/UICC cancer staging manuals, 8th edition. The Worldwide Esophageal Cancer Collaboration provided data for 22,654 patients with epithelial esophageal cancers; 7,773 had pathologic assessment after neoadjuvant therapy. Risk-adjusted survival for each patient was developed. Random forest analysis identified data-driven neoadjuvant pathologic stage groups wherein survival decreased monotonically with increasing group, was distinctive between groups, and homogeneous within groups. An additional analysis produced data-driven anatomic neoadjuvant pathologic stage groups based only on ypT, ypN, and ypM categories. The AJCC Upper GI Task Force, by smoothing, simplifying, expanding, and assessing clinical applicability, produced consensus neoadjuvant pathologic stage groups. Grade and location were much less discriminating for stage grouping ypTNM than pTNM. Data-driven stage grouping without grade and location produced nearly identical groups for squamous cell carcinoma and adenocarcinoma. However, ypTNM groups and their associated survival differed from pTNM. The need for consensus process was minimal. The consensus groups, identical for both cell types were as follows: ypStage I comprised ypT0-2N0M0; ypStage II ypT3N0M0; ypStage IIIA ypT0-2N1M0; ypStage IIIB ypT3N1M0, ypT0-3N2, and ypT4aN0M0; ypStage IVA ypT4aN1-2, ypT4bN0-2, and ypTanyN3M0; and ypStage IVB ypTanyNanyM1. Absence of equivalent pathologic (pTNM) categories for the peculiar neoadjuvant pathologic categories ypTisN0-3M0 and ypT0N0-3M0, dissimilar stage group compositions, and markedly different early- and intermediate-stage survival necessitated a unified, unique set of stage grouping for patients of either cell type who receive neoadjuvant therapy. © 2016 International Society for Diseases of the Esophagus.

Efficacy of Rotigotine at Different Stages of Parkinson's Disease Symptom Severity and Disability: A Post Hoc Analysis According to Baseline Hoehn and Yahr Stage.

PubMed

Giladi, Nir; Nicholas, Anthony P; Asgharnejad, Mahnaz; Dohin, Elisabeth; Woltering, Franz; Bauer, Lars; Poewe, Werner

2016-10-19

The efficacy of rotigotine has been demonstrated in studies of patients with early (i.e. not receiving levodopa) and advanced (i.e. not adequately controlled on levodopa; average 2.5 h/day in 'off' state) Parkinson's disease (PD). To further investigate the efficacy of rotigotine transdermal patch across different stages of PD symptom severity and functional disability, according to baseline Hoehn and Yahr (HY) staging. Post hoc analysis of six placebo-controlled studies of rotigotine in patients with early PD (SP506, SP512, SP513; rotigotine ≤8 mg/24 h) or advanced-PD (CLEOPATRA-PD, PREFER, SP921; rotigotine ≤16 mg/24 h). Data were pooled and analyzed according to baseline HY stage (1, 2, 3 or 4) for change from baseline to end of maintenance in Unified Parkinson's Disease Rating Scale (UPDRS) II (activities of daily living), UPDRS III (motor) and UPDRS II+III; statistical tests are exploratory. Data were available for 2057 patients (HY 1 : 262; HY 2 : 1230; HY 3 : 524; HY 4 : 41). Patients at higher HY stages were older, had a longer time since PD diagnosis and higher baseline UPDRS II+III scores vs patients at lower HY stages. Rotigotine improved UPDRS II+III versus placebo for each individual HY stage (p < 0.05 for each HY stage), with treatment differences increasing with increasing HY stages. Similar results were observed for UPDRS II and UPDRS III. This post hoc analysis suggests that rotigotine may be efficacious across a broad range of progressive stages of PD symptom severity and functional disability (HY stages 1-4).

Survival Advantage Associated with Decrease in Stage at Detection from Stage IIIC to Stage IIIA Epithelial Ovarian Cancer

PubMed Central

Lefringhouse, Jason; Pavlik, Edward; Miller, Rachel; DeSimone, Christopher; Ueland, Frederick; Kryscio, Richard; van Nagell, J. R.

2014-01-01

Objective. The aim of this study was to document the survival advantage of lowering stage at detection from Stage IIIC to Stage IIIA epithelial ovarian cancer. Methods. Treatment outcomes and survival were evaluated in patients with Stage IIIA and Stage IIIC epithelial ovarian cancer treated from 2000 to 2009 at the University of Kentucky Markey Cancer Center (UKMCC) and SEER institutions. Results. Cytoreduction to no visible disease (P < 0.0001) and complete response to platinum-based chemotherapy (P < 0.025) occurred more frequently in Stage IIIA than in Stage IIIC cases. Time to progression was shorter in patients with Stage IIIC ovarian cancer (17 ± 1 months) than in those with Stage II1A disease (36 ± 8 months). Five-year overall survival (OS) improved from 41% in Stage IIIC patients to 60% in Stage IIIA patients treated at UKMCC and from 37% to 56% in patients treated at SEER institutions for a survival advantage of 19% in both data sets. 53% of Stage IIIA and 14% of Stage IIIC patients had NED at last followup. Conclusions. Decreasing stage at detection from Stage IIIC to stage IIIA epithelial ovarian cancer is associated with a 5-year survival advantage of nearly 20% in patients treated by surgical tumor cytoreduction and platinum-based chemotherapy. PMID:25254047

The Functional Arm Scale for Throwers (FAST)-Part I: The Design and Development of an Upper Extremity Region-Specific and Population-Specific Patient-Reported Outcome Scale for Throwing Athletes.

PubMed

Sauers, Eric L; Bay, R Curtis; Snyder Valier, Alison R; Ellery, Traci; Huxel Bliven, Kellie C

2017-03-01

Upper extremity (UE) region-specific, patient-reported outcome (PRO) scales assess injuries to the UE but do not account for the demands of overhead throwing athletes or measure patient-oriented domains of health-related quality of life (HRQOL). To develop the Functional Arm Scale for Throwers (FAST), a UE region-specific and population-specific PRO scale that assesses multiple domains of disablement in throwing athletes with UE injuries. In stage I, a beta version of the scale was developed for subsequent factor identification, final item reduction, and construct validity analysis during stage II. Descriptive laboratory study. Three-stage scale development was utilized: Stage I (item generation and initial item reduction) and stage II (factor analysis, final item reduction, and construct validity) are reported herein, and stage III (establishment of measurement properties [reliability and validity]) will be reported in a companion paper. In stage I, a beta version was developed, incorporating National Center for Medical Rehabilitation Research disablement domains and ensuring a blend of sport-related and non-sport-related items. An expert panel and focus group assessed importance and interpretability of each item. During stage II, the FAST was reduced, preserving variance characteristics and factor structure of the beta version and construct validity of the final FAST scale. During stage I, a 54-item beta version and a separate 9-item pitcher module were developed. During stage II, a 22-item FAST and 9-item pitcher module were finalized. The factor solution for FAST scale items included pain (n = 6), throwing (n = 10), activities of daily living (n = 5), psychological impact (n = 4), and advancement (n = 3). The 6-item pain subscale crossed factors. The remaining subscales and pitcher module are distinctive, correlated, and internally consistent and may be interpreted individually or combined. This article describes the development of the FAST, which assesses

Statistical inference for extended or shortened phase II studies based on Simon's two-stage designs.

PubMed

Zhao, Junjun; Yu, Menggang; Feng, Xi-Ping

2015-06-07

Simon's two-stage designs are popular choices for conducting phase II clinical trials, especially in the oncology trials to reduce the number of patients placed on ineffective experimental therapies. Recently Koyama and Chen (2008) discussed how to conduct proper inference for such studies because they found that inference procedures used with Simon's designs almost always ignore the actual sampling plan used. In particular, they proposed an inference method for studies when the actual second stage sample sizes differ from planned ones. We consider an alternative inference method based on likelihood ratio. In particular, we order permissible sample paths under Simon's two-stage designs using their corresponding conditional likelihood. In this way, we can calculate p-values using the common definition: the probability of obtaining a test statistic value at least as extreme as that observed under the null hypothesis. In addition to providing inference for a couple of scenarios where Koyama and Chen's method can be difficult to apply, the resulting estimate based on our method appears to have certain advantage in terms of inference properties in many numerical simulations. It generally led to smaller biases and narrower confidence intervals while maintaining similar coverages. We also illustrated the two methods in a real data setting. Inference procedures used with Simon's designs almost always ignore the actual sampling plan. Reported P-values, point estimates and confidence intervals for the response rate are not usually adjusted for the design's adaptiveness. Proper statistical inference procedures should be used.

Finishing occlusion in Class II or Class III molar relation: therapeutic Class II and III.

PubMed

Nangia, A; Darendeliler, M A

2001-11-01

The most frequent extraction regime consists of the removal of upper and lower premolars. Depending on anchorage requirements, camouflage treatment options, surgical intervention, or the absence of teeth in only one arch, it may become necessary to finalize the occlusion with a one-dental-unit discrepancy between the upper and lower dental arches. Guidelines are presented for finishing occlusions in Class II or Class III molar relation.

Biomechanical Analysis of Cuboid Osteotomy Lateral Column Lengthening for Stage II B Adult-Acquired Flatfoot Deformity: A Cadaveric Study.

PubMed

Zhou, Haichao; Ren, Haoyang; Li, Chunguang; Xia, Jiang; Yu, Guangrong; Yang, Yunfeng

2017-01-01

Purpose . To investigate the effect of cuboid osteotomy lateral column lengthening (LCL) for the correction of stage II B adult-acquired flatfoot deformity in cadaver. Methods . Six cadaver specimens were loaded to 350 N. Flatfoot models were established and each was evaluated radiographically and pedobarographically in the following conditions: (1) intact foot, (2) flatfoot, and (3) cuboid osteotomy LCL (2, 3, 4, and 5 mm). Results . Compared with the flatfoot model, the LCLs showed significant correction of talonavicular coverage on anteroposterior radiographs and talus-first metatarsal angle on both anteroposterior and lateral radiographs ( p < .05). Compared with the intact foot, the above angles of the LCLs showed no significant difference except the 2 mm LCL. In terms of forefoot pressure, medial pressure of the 2 mm LCL ( p = .044) and lateral pressure of the 3, 4, and 5 mm LCLs showed statistical differences ( p < .05), but lateral pressure of the 3 mm LCL was not more than the intact foot as compared to the 4 and 5 mm LCLs, which was less than medial pressure. Conclusion . Cuboid osteotomy LCL procedure avoids damage to subtalar joint and has a good effect on correction of stage II B adult-acquired flatfoot deformity with a 3 mm lengthening in cadavers.

The expression ratio of Map7/B2M is prognostic for survival in patients with stage II colon cancer.

PubMed

Blum, Craig; Graham, Amanda; Yousefzadeh, Matt; Shrout, Jessica; Benjamin, Katie; Krishna, Murli; Hoda, Raza; Hoda, Rana; Cole, David J; Garrett-Mayer, Elizabeth; Reed, Carolyn; Wallace, Michael; Mitas, Michael

2008-09-01

Colorectal cancer (CRC) is the second most frequent cause of cancer-related death in the United States. To determine whether certain molecular markers might be prognostic for survival, we measured by quantitative real-time RT-PCR the expression levels of 15 previously studied genes that are known to be up-regulated or down-regulated in the progression of epithelial cancers. The tumor samples were extracted from formalin-fixed paraffin-embedded primary tissues derived from patients with Stage II CRC who developed disease recurrence within two years (n=10), or were disease-free for at least 4 years (n=12). We were able to determine, by AUC curve analysis, that the ratio of microtubule associated protein 7 (Map7)/B2M was predictive of outcome in our sample set. Further, using Kaplan-Meier survival analysis, we observed significantly different curves as a function of marker positivity for the Map7/B2M (p=0.0001; HR=11) expression ratio. This suggests that the expression ratio of Map7/B2M may serve as a valuable prognostic marker in patients with Stage II colon cancer, and potentially guide therapeutic decision making.

The expression ratio of Map7/B2M is prognostic for survival in patients with stage II colon cancer

PubMed Central

BLUM, CRAIG; GRAHAM, AMANDA; YOUSEFZADEH, MATT; SHROUT, JESSICA; BENJAMIN, KATIE; KRISHNA, MURLI; HODA, RAZA; HODA, RANA; COLE, DAVID J.; GARRETT-MAYER, ELIZABETH; REED, CAROLYN; WALLACE, MICHAEL; MITAS, MICHAEL

2012-01-01

Colorectal cancer (CRC) is the second most frequent cause of cancer-related death in the United States. To determine whether certain molecular markers might be prognostic for survival, we measured by quantitative real-time RT-PCR the expression levels of 15 previously studied genes that are known to be up-regulated or down-regulated in the progression of epithelial cancers. The tumor samples were extracted from formalin-fixed paraffin-embedded primary tissues derived from patients with Stage II CRC who developed disease recurrence within two years (n=10), or were disease-free for at least 4 years (n=12). We were able to determine, by AUC curve analysis, that the ratio of microtubule associated protein 7 (Map7)/B2M was predictive of outcome in our sample set. Further, using Kaplan-Meier survival analysis, we observed significantly different curves as a function of marker positivity for the Map7/B2M (p=0.0001; HR=11) expression ratio. This suggests that the expression ratio of Map7/B2M may serve as a valuable prognostic marker in patients with Stage II colon cancer, and potentially guide therapeutic decision making. PMID:18695889

Esophageal dysfunction in different stages of Parkinson's disease.

PubMed

Suttrup, I; Suttrup, J; Suntrup-Krueger, S; Siemer, M-L; Bauer, J; Hamacher, C; Oelenberg, S; Domagk, D; Dziewas, R; Warnecke, T

2017-01-01

Dysphagia is a clinically relevant symptom in patients with Parkinson's disease (PD) leading to pronounced reduction in quality of life and other severe complications. Parkinson's disease-related dysphagia may affect the oral and pharyngeal, as well as the esophageal phase of swallowing. To examine the nature and extend of esophageal dysphagia in different stages of PD and their relation to oropharyngeal dysfunction, we examined 65 PD patients (mean age 66.3±9.7 years, mean disease duration 7.9±5.8 years, mean Hoehn & Yahr [H&Y] stage 2.89±0.91) and divided into three groups (early [H&Y I+II; n=21], intermediate [H&Y III; n=25], and advanced stadium [H&Y IV+V; n=19]), using esophageal high-resolution manometry (HRM) to detect esophageal motor disorders. Oropharyngeal impairment was assessed using fiberoptic endoscopic evaluation of swallowing. Major esophageal motor disorders were detected in nearly one third of the PD patients. Minor impairment of the esophageal body was present in 95% of participants and throughout all disease stages with pathological findings especially in peristalsis and intrabolus pressure (IBP). The IBP was found to significantly increase in the advanced stadium. Although dysfunction of the upper and lower esophageal sphincters was observed in individual patients, alterations in these esophageal segments revealed no statistical significance compared with normative data. No clear association was found between the occurrence of oropharyngeal dysphagia and esophageal impairment. Esophageal body impairment in PD is a frequent phenomenon during all disease stages, which possibly reflects α-synucleinopathy in the enteric nervous system. © 2016 John Wiley & Sons Ltd.

Upper-stage space shuttle propulsion by means of separate scramjet and rocket engines

NASA Technical Reports Server (NTRS)

Franciscus, L. C.; Allen, J. L.

1972-01-01

A preliminary mission study of a reusable vehicle from staging to orbit indicates payload advantages for a dual-propulsion system consisting of separate scramjet and rocket engines. In the analysis the scramjet operated continuously and the initiation of rocket operation was varied. For a stage weight of 500,000 lb the payload was 10.4 percent of stage weight or 70 percent greater than that of a comparable all-rocket-powered stage. When compared with a reusable two-state rocket vehicle having 50,000 lb payload, the use of the dual propulsion system for the second stage resulted in significant decreases in lift-off weight and empty weight, indicating possible lower hardware costs.

The second stage of a Titan II rocket is lifted for mating at the launch tower, Vandenberg AFB

NASA Technical Reports Server (NTRS)

2000-01-01

At the launch tower, Vandenberg Air Force Base, Calif., the second stage of a Titan II rocket is lifted to vertical. The Titan will power the launch of a National Oceanic and Atmospheric Administration (NOAA-L) satellite scheduled no earlier than Sept. 12. NOAA-L is part of the Polar-Orbiting Operational Environmental Satellite (POES) program that provides atmospheric measurements of temperature, humidity, ozone and cloud images, tracking weather patterns that affect the global weather and climate. Universal Point of Care Testing for Lynch Syndrome in Patients with Upper Tract Urothelial Carcinoma.

PubMed

Metcalfe, Michael J; Petros, Firas G; Rao, Priya; Mork, Maureen E; Xiao, Lianchun; Broaddus, Russell R; Matin, Surena F

2018-01-01

Patients with Lynch syndrome are at risk for upper tract urothelial carcinoma. We sought to identify the incidence and most reliable means of point of care screening for Lynch syndrome in patients with upper tract urothelial carcinoma. A total of 115 consecutive patients with upper tract urothelial carcinoma without a history of Lynch syndrome were universally screened during followup from January 2013 through July 2016. We evaluated patient and family history using AMS (Amsterdam criteria) I and II, and tumor immunohistochemistry for mismatch repair proteins and microsatellite instability. Patients who were positive for AMS I/II, microsatellite instability or immunohistochemistry were classified as potentially having Lynch syndrome and referred for clinical genetic analysis and counseling. Patients with known Lynch syndrome served as positive controls. Of the 115 patients 16 (13.9%) screened positive for potential Lynch syndrome. Of these patients 7.0% met AMS II criteria, 11.3% had loss of at least 1 mismatch repair protein and 6.0% had high microsatellite instability. All 16 patients were referred for germline testing, 9 completed genetic analysis and counseling, and 6 were confirmed to have Lynch syndrome. All 7 patients with upper tract urothelial carcinoma who had a known history of Lynch syndrome were positive for AMS II criteria and at least a single mismatch repair protein loss while 5 of 6 had high microsatellite instability. We identified 13.9% of upper tract urothelial carcinoma cases as potential Lynch syndrome and 5.2% as confirmed Lynch syndrome at the point of care. These findings have important implications for universal screening of upper tract urothelial carcinoma, representing one of the highest rates of undiagnosed genetic disease in a urological cancer. Copyright © 2018 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Involvement of Difference in Decrease of Hemoglobin Level in Poor Prognosis of Stage I and II Nasopharyngeal Carcinoma: Implication in Outcome of Radiotherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gao Jin; State Key Laboratory of Oncology in Southern China, Sun Yat-Sen University, Guangzhou; Department of Radiation Oncology, Anhui provincial hospital, Hefei

2012-03-15

Purpose: To investigate the effect of hemoglobin (Hb) concentration and the difference in its decrease during treatment on outcome of radiotherapy (RT) alone for patients with Stage I and II nasopharyngeal carcinoma. Methods and Materials: A total of 572 patients with Stage I-II nasopharyngeal carcinoma with RT alone between January 2001 and December 2004 were retrospectively analyzed. Patient characteristics, tumor variables, and Hb level, including pre-RT Hb, mid-RT Hb, and dynamic change of Hb between pre- and post- RT and its difference in decrease ( White-Up-Pointing-Small-Triangle Hb) were subjected to univariate and multivariable analysis to identify factors that predict disease-specificmore » survival (DSS), local regional recurrence-free survival (LRFS), and metastases-free survival (MFS). Results: The 5-year DSS was poorer in the Hb continuous decrease group than in the Hb noncontinuous decrease group (84% vs. 89%; p = 0.008). There was poorer 5-year DSS in patients with White-Up-Pointing-Small-Triangle Hb of >11.5 g/L than in those with White-Up-Pointing-Small-Triangle Hb of {<=}11.5 g/L (82% vs. 89%; p = 0.001), and poorer LRFS (79% vs. 83%; p = 0.035). Univariate and multivariate analysis showed that Hb decrease difference with greater than 11.5 g/L was an independent prognostic factor for DSS and LRFS. Conclusions: The difference in decrease of Hb level during the course of radiation treatment appeared as a poor prognostic factor in Stage I and II nasopharyngeal carcinoma patients.« less

Upper Paleozoic Marine Shale Characteristics and Exploration Prospects in the Northwestern Guizhong Depression, South China

NASA Astrophysics Data System (ADS)

Zhu, Zhenhong; Yao, Genshun; Lou, Zhanghua; Jin, Aimin; Zhu, Rong; Jin, Chong; Chen, Chao

2018-05-01

Multiple sets of organic-rich shales developed in the Upper Paleozoic of the northwestern Guizhong Depression in South China. However, the exploration of these shales is presently at a relatively immature stage. The Upper Paleozoic shales in the northwestern Guizhong Depression, including the Middle Devonian Luofu shale, the Nabiao shale, and the Lower Carboniferous Yanguan shale, were investigated in this study. Mineral composition analysis, organic matter analysis (including total organic carbon (TOC) content, maceral of kerogen and the vitrinite reflection (Ro)), pore characteristic analysis (including porosity and permeability, pore type identification by SEM, and pore size distribution by nitrogen sorption), methane isothermal sorption test were conducted, and the distribution and thickness of the shales were determined, Then the characteristics of the two target shales were illustrated and compared. The results show that the Upper Paleozoic shales have favorable organic matter conditions (mainly moderate to high TOC content, type I and II1 kerogen and high to over maturity), good fracability potential (brittleness index (BI) > 40%), multiple pore types, stable distribution and effective thickness, and good methane sorption capacity. Therefore, the Upper Paleozoic shales in the northern Guizhong Depression have good shale gas potential and exploration prospects. Moreover, the average TOC content, average BI, thickness of the organic-rich shale (TOC > 2.0 wt%) and the shale gas resources of the Middle Devonian shales are better than those of the Lower Carboniferous shale. The Middle Devonian shales have better shale gas potential and exploration prospects than the Lower Carboniferous shales.

Pathologic Factors Associated with Prognosis after Adjuvant Chemotherapy in Stage II/III Microsatellite-Unstable Colorectal Cancers

PubMed Central

Kim, Jung Ho; Bae, Jeong Mo; Oh, Hyeon Jeong; Lee, Hye Seung; Kang, Gyeong Hoon

2015-01-01

Background: Although there are controversies regarding the benefit of fluoropyrimidine-based adjuvant chemotherapy in patients with microsatellite instability–high (MSI-H) colorectal cancer (CRC), the pathologic features affecting postchemotherapeutic prognosis in these patients have not been fully identified yet. Methods: A total of 26 histopathologic and immunohistochemical factors were comprehensively evaluated in 125 stage II or III MSI-H CRC patients who underwent curative resection followed by fluoropyrimidine-based adjuvant chemotherapy. We statistically analyzed the associations of these factors with disease-free survival (DFS). Results: Using a Kaplan- Meier analysis with log-rank test, we determined that ulceroinfiltrative gross type (p=.003), pT4 (p<.001), pN2 (p=.002), perineural invasion (p=.001), absence of peritumoral lymphoid reaction (p=.041), signet ring cell component (p=.006), and cribriform comedo component (p=.004) were significantly associated with worse DFS in patients receiving oxaliplatin-based adjuvant chemotherapy (n=45). By contrast, pT4 (p<.001) and tumor budding-positivity (p=.032) were significant predictors of poor survival in patients receiving non-oxaliplatin–based adjuvant chemotherapy (n=80). In Cox proportional hazards regression model-based univariate and multivariate analyses, pT category (pT1-3 vs pT4) was the only significant prognostic factor in patients receiving non-oxaliplatin–based adjuvant chemotherapy, whereas pT category, signet ring cell histology and cribriform comedo histology remained independent prognostic factors in patients receiving oxaliplatin-based adjuvant chemotherapy. Conclusions: pT4 status is the most significant pathologic determinant of poor outcome after fluoropyrimidine-based adjuvant chemotherapy in patients with stage II/III MSI-H CRC. PMID:26148739

Black breast cancer survivors experience greater upper extremity disability.

PubMed

Dean, Lorraine T; DeMichele, Angela; LeBlanc, Mously; Stephens-Shields, Alisa; Li, Susan Q; Colameco, Chris; Coursey, Morgan; Mao, Jun J

2015-11-01

Over one-third of breast cancer survivors experience upper extremity disability. Black women present with factors associated with greater upper extremity disability, including: increased body mass index (BMI), more advanced disease stage at diagnosis, and varying treatment type compared with Whites. No prior research has evaluated the relationship between race and upper extremity disability using validated tools and controlling for these factors. Data were drawn from a survey study among 610 women with stage I-III hormone receptor positive breast cancer. The disabilities of the arm, shoulder and hand (QuickDASH) is an 11-item self-administered questionnaire that has been validated for breast cancer survivors to assess global upper extremity function over the past 7 days. Linear regression and mediation analysis estimated the relationships between race, BMI and QuickDASH score, adjusting for demographics and treatment types. Black women (n = 98) had 7.3 points higher average QuickDASH scores than White (n = 512) women (p < 0.001). After adjusting for BMI, age, education, cancer treatment, months since diagnosis, and aromatase inhibitor status, Black women had an average 4-point (95 % confidence interval 0.18-8.01) higher QuickDASH score (p = 0.04) than White women. Mediation analysis suggested that BMI attenuated the association between race and disability by 40 %. Even several years post-treatment, Black breast cancer survivors had greater upper extremity disability, which was partially mediated by higher BMIs. Close monitoring of high BMI Black women may be an important step in reducing disparities in cancer survivorship. More research is needed on the relationship between race, BMI, and upper extremity disability.

A comparison of 12-gene colon cancer assay gene expression in African American and Caucasian patients with stage II colon cancer.

PubMed

Govindarajan, Rangaswamy; Posey, James; Chao, Calvin Y; Lu, Ruixiao; Jadhav, Trafina; Javed, Ahmed Y; Javed, Awais; Mahmoud, Fade A; Osarogiagbon, Raymond U; Manne, Upender

2016-06-18

African American (AA) colon cancer patients have a worse prognosis than Caucasian (CA) colon cancer patients, however, reasons for this disparity are not well understood. To determine if tumor biology might contribute to differential prognosis, we measured recurrence risk and gene expression using the Oncotype DX® Colon Cancer Assay (12-gene assay) and compared the Recurrence Score results and gene expression profiles between AA patients and CA patients with stage II colon cancer. We retrieved demographic, clinical, and archived tumor tissues from stage II colon cancer patients at four institutions. The 12-gene assay and mismatch repair (MMR) status were performed by Genomic Health (Redwood City, California). Student's t-test and the Wilcoxon rank sum test were used to compare Recurrence Score data and gene expression data from AA and CA patients (SAS Enterprise Guide 5.1). Samples from 122 AA and 122 CA patients were analyzed. There were 118 women (63 AA, 55 CA) and 126 men (59 AA, 67 CA). Median age was 66 years for AA patients and 68 for CA patients. Age, gender, year of surgery, pathologic T-stage, tumor location, the number of lymph nodes examined, lymphovascular invasion, and MMR status were not significantly different between groups (p = 0.93). The mean Recurrence Score result for AA patients (27.9 ± 12.8) and CA patients (28.1 ± 11.8) was not significantly different and the proportions of patients with high Recurrence Score values (≥41) were similar between the groups (17/122 AA; 15/122 CA). None of the gene expression variables, either single genes or gene groups (cell cycle group, stromal group, BGN1, FAP, INHBA1, Ki67, MYBL2, cMYC and GADD45B), was significantly different between the racial groups. After controlling for clinical and pathologic covariates, the means and distributions of Recurrence Score results and gene expression profiles showed no statistically significant difference between patient groups. The distribution of

Orion Stage Adapter Arrival

NASA Image and Video Library

2018-04-03

NASA's Super Guppy aircraft touches down at the Shuttle Landing Facility at the agency's Kennedy Space Center in Florida. The Super Guppy is carrying the Orion Stage Adapter (OSA), the second flight-hardware section of NASA's Space Launch System (SLS) rocket that has arrived at Kennedy. The OSA will connect the Orion spacecraft to the upper part of the SLS rocket, the interim cryogenic propulsion stage (ICPS). Both the OSA and ICPS are being stored for processing in the center's Space Station Processing Facility in preparation for Exploration Mission-1, the first uncrewed, integrated launch of the SLS rocket and Orion spacecraft.

Revised International Staging System for Multiple Myeloma: A Report From International Myeloma Working Group

PubMed Central

Palumbo, Antonio; Avet-Loiseau, Hervé; Oliva, Stefania; Lokhorst, Henk M.; Goldschmidt, Hartmut; Rosinol, Laura; Richardson, Paul; Caltagirone, Simona; Lahuerta, Juan José; Facon, Thierry; Bringhen, Sara; Gay, Francesca; Attal, Michel; Passera, Roberto; Spencer, Andrew; Offidani, Massimo; Kumar, Shaji; Musto, Pellegrino; Lonial, Sagar; Petrucci, Maria T.; Orlowski, Robert Z.; Zamagni, Elena; Morgan, Gareth; Dimopoulos, Meletios A.; Durie, Brian G.M.; Anderson, Kenneth C.; Sonneveld, Pieter; San Miguel, Jésus; Cavo, Michele; Rajkumar, S. Vincent; Moreau, Philippe

2015-01-01

Purpose The clinical outcome of multiple myeloma (MM) is heterogeneous. A simple and reliable tool is needed to stratify patients with MM. We combined the International Staging System (ISS) with chromosomal abnormalities (CA) detected by interphase fluorescent in situ hybridization after CD138 plasma cell purification and serum lactate dehydrogenase (LDH) to evaluate their prognostic value in newly diagnosed MM (NDMM). Patients and Methods Clinical and laboratory data from 4,445 patients with NDMM enrolled onto 11 international trials were pooled together. The K-adaptive partitioning algorithm was used to define the most appropriate subgroups with homogeneous survival. Results ISS, CA, and LDH data were simultaneously available in 3,060 of 4,445 patients. We defined the following three groups: revised ISS (R-ISS) I (n = 871), including ISS stage I (serum β2-microglobulin level < 3.5 mg/L and serum albumin level ≥ 3.5 g/dL), no high-risk CA [del(17p) and/or t(4;14) and/or t(14;16)], and normal LDH level (less than the upper limit of normal range); R-ISS III (n = 295), including ISS stage III (serum β2-microglobulin level > 5.5 mg/L) and high-risk CA or high LDH level; and R-ISS II (n = 1,894), including all the other possible combinations. At a median follow-up of 46 months, the 5-year OS rate was 82% in the R-ISS I, 62% in the R-ISS II, and 40% in the R-ISS III groups; the 5-year PFS rates were 55%, 36%, and 24%, respectively. Conclusion The R-ISS is a simple and powerful prognostic staging system, and we recommend its use in future clinical studies to stratify patients with NDMM effectively with respect to the relative risk to their survival. PMID:26240224

Efficacy of Rotigotine at Different Stages of Parkinson’s Disease Symptom Severity and Disability: A Post Hoc Analysis According to Baseline Hoehn and Yahr Stage

PubMed Central

Giladi, Nir; Nicholas, Anthony P.; Asgharnejad, Mahnaz; Dohin, Elisabeth; Woltering, Franz; Bauer, Lars; Poewe, Werner

2016-01-01

Background: The efficacy of rotigotine has been demonstrated in studies of patients with early (i.e. not receiving levodopa) and advanced (i.e. not adequately controlled on levodopa; average 2.5 h/day in ‘off’ state) Parkinson’s disease (PD). Objective: To further investigate the efficacy of rotigotine transdermal patch across different stages of PD symptom severity and functional disability, according to baseline Hoehn and Yahr (HY) staging. Methods: Post hoc analysis of six placebo-controlled studies of rotigotine in patients with early PD (SP506, SP512, SP513; rotigotine ≤8 mg/24 h) or advanced-PD (CLEOPATRA-PD, PREFER, SP921; rotigotine ≤16 mg/24 h). Data were pooled and analyzed according to baseline HY stage (1, 2, 3 or 4) for change from baseline to end of maintenance in Unified Parkinson’s Disease Rating Scale (UPDRS) II (activities of daily living), UPDRS III (motor) and UPDRS II+III; statistical tests are exploratory. Results: Data were available for 2057 patients (HY 1 : 262; HY 2 : 1230; HY 3 : 524; HY 4 : 41). Patients at higher HY stages were older, had a longer time since PD diagnosis and higher baseline UPDRS II+III scores vs patients at lower HY stages. Rotigotine improved UPDRS II+III versus placebo for each individual HY stage (p < 0.05 for each HY stage), with treatment differences increasing with increasing HY stages. Similar results were observed for UPDRS II and UPDRS III. Conclusions: This post hoc analysis suggests that rotigotine may be efficacious across a broad range of progressive stages of PD symptom severity and functional disability (HY stages 1–4). PMID:27567886

Validation of the Omron M3 Intellisense (HEM-7051-E) upper arm blood pressure monitor, for self-measurement, according to the European Society of Hypertension International Protocol revision 2010 in a stage 3-5 chronic kidney disease population.

PubMed

Akpolat, Tekin; Erdem, Emre; Aydogdu, Türkan

2012-01-01

Encouragement of home blood pressure (BP) monitoring has a great potential to improve hypertension control rates. The purpose of this study was to test validation of the Omron M3 Intellisense (HEM-7051-E) upper arm BP measuring monitor for self-measurement according to the European Society of Hypertension International Protocol revision 2010 (ESH-IP2) in stage 3-5 chronic kidney disease (CKD) patients. 66 patients having CKD stage 3-5 were included in the study. Nine consecutive measurements were made according to the ESH-IP2 protocol. The Omron M3 Intellisense device fulfills the validation criteria of the ESH-IP2 for stage 3-5 CKD patients. Although arterial stiffness can affect accurate BP measurement, there are limited data regarding the use of automated oscillometric devices in CKD. To our knowledge, this is the first study investigating validation of an oscillometric device in stage 3-5 predialysis CKD patients. This study validates the Omron M3 Intellisense upper arm device for stage 3-5 CKD patients. New validation studies investigating other oscillometric sphygmomanometers for CKD patients and involvement of nephrologists in these studies have great potential to increase patient care in CKD. Copyright © 2011 S. Karger AG, Basel.

Targeting Angiotensin II Type-1 Receptor (AT1R) Inhibits the Harmful Phenotype of Plasmodium-Specific CD8+ T Cells during Blood-Stage Malaria.

PubMed

Silva-Filho, João L; Caruso-Neves, Celso; Pinheiro, Ana A S

2017-01-01

CD8 + T-cell response is critical in the pathogenesis of cerebral malaria during blood-stage. Our group and other have been shown that angiotensin II (Ang II) and its receptor AT 1 (AT 1 R), a key effector axis of renin-angiotensin system (RAS), have immune regulatory effects on T cells. Previously, we showed that inhibition of AT 1 R signaling protects mice against the lethal disease induced by Plasmodium berghei ANKA infection However, most of the Ang II/AT 1 R actions were characterized by using only pharmacological approaches, the effects of which may not always be due to a specific receptor blockade. In addition, the mechanisms of action of the AT 1 R in inducing the pathogenic activity of Plasmodium -specific CD8 + T cells during blood-stage were not determined. Here, we examined how angiotensin II/AT 1 R axis promotes the harmful response of Plasmodium -specific CD8 + T-cell during blood-stage by using genetic and pharmacological approaches. We evaluated the response of wild-type (WT) and AT 1 R -/- Plasmodium -specific CD8 + T cells in mice infected with a transgenic PbA lineage expressing ovalbumin; and in parallel infected mice receiving WT Plasmodium -specific CD8 + T cells were treated with losartan (AT 1 R antagonist) or captopril (ACE inhibitor). Both, AT 1 R -/- OT-I cells and WT OT-I cells from losartan- or captopril-treated mice showed lower expansion, reduced IL-2 production and IL-2Rα expression, lower activation (lower expression of CD69, CD44 and CD160) and lower exhaustion profiles. AT 1 R -/- OT-I cells also exhibit lower expression of the integrin LFA-1 and the chemokine receptors CCR5 and CXCR3, known to play a key role in the development of cerebral malaria. Moreover, AT 1 R -/- OT-I cells produce lower amounts of IFN-γ and TNF-α and show lower degranulation upon restimulation. In conclusion, our results show the pivotal mechanisms of AT 1 R-induced harmful phenotype of Plasmodium -specific CD8 + T cells during blood-stage malaria.

An Updated Zero Boil-Off Cryogenic Propellant Storage Analysis Applied to Upper Stages or Depots in a LEO Environment

NASA Technical Reports Server (NTRS)

Plachta, David; Kittel, Peter

2003-01-01

Previous efforts have shown the analytical benefits of zero boil-off (ZBO) cryogenic propellant storage in launch vehicle upper stages of Mars transfer vehicles for conceptual Mars Missions. However, recent NASA mission investigations have looked at a different and broad array of missions, including a variety of orbit transfer vehicle (OTV) propulsion concepts, some requiring cryogenic storage. For many of the missions, this vehicle will remain for long periods (greater than one week) in low earth orbit (LEO), a relatively warm thermal environment. Under this environment, and with an array of tank sizes and propellants, the performance of a ZBO cryogenic storage system is predicted and compared with a traditional, passive-only storage concept. The results show mass savings over traditional, passive-only cryogenic storage when mission durations are less than one week in LEO for oxygen, two weeks for methane, and roughly 2 months for LH2. Cryogenic xenon saves mass over passive storage almost immediately.

Predictive value of PET-CT for pathological response in stages II and III breast cancer patients following neoadjuvant chemotherapy with docetaxel.

PubMed

García García-Esquinas, Marta A; Arrazola García, Juan; García-Sáenz, José A; Furió-Bacete, V; Fuentes Ferrer, Manuel E; Ortega Candil, Aída; Cabrera Martín, María N; Carreras Delgado, José L

2014-01-01

To prospectively study the value of PET-CT with fluorine-18 fluorodeoxyglucose (FDG) to predict neoadjuvant chemotherapy (NAC) response of locoregional disease of stages II and III breast cancer patients. A written informed consent and approval were obtained from the Ethics Committee. PET-CT accuracy in the prediction of pathologic complete response (pCR) after NAC was studied in primary tumors and lymph node metastasis in 43 women (mean age: 50 years: range: 27-71 years) with histologically proven breast cancer between December 2009 and January 2011. PET-CT was performed at baseline and after NAC. SUV(max) percentage changes (ΔSUV(max)) were compared with pathology findings at surgery. Receiver-operator characteristic (ROC) analysis was used to discriminate between locoregional pCR and non-pCR. In patients not achieving pCR, it was investigated if ΔSUV(max) could accurately identify the residual cancer burden (RCB) classes: RCB-I (minimal residual disease (MRD)), RCB-II (moderate RD), and RCB-III (extensive RD). pCR was obtained in 11 patients (25.6%). Residual disease was found in 32 patients (74.4%): 16 (37.2%) RCB-I, 15 (35.6%) RCB-II and 2 (4.7%) RCB-III. Sensitivity, specificity, and accuracy to predict pCR were 90.9%, 90.6%, and 90.7%, respectively. Specificity was 94.1% in the identification of a subset of patients who had either pCR or MRD. Accuracy of ΔSUV(max) in the locoregional disease of stages II and III breast cancer patients after NAC is high for the identification of pCR cases. Its specificity is potentially sufficient to identify a subgroup of patients who could be managed with conservative surgery. Copyright © 2013 Elsevier España, S.L. and SEMNIM. All rights reserved.

Validation of the 12-gene colon cancer recurrence score in NSABP C-07 as a predictor of recurrence in patients with stage II and III colon cancer treated with fluorouracil and leucovorin (FU/LV) and FU/LV plus oxaliplatin.

PubMed

Yothers, Greg; O'Connell, Michael J; Lee, Mark; Lopatin, Margarita; Clark-Langone, Kim M; Millward, Carl; Paik, Soonmyung; Sharif, Saima; Shak, Steven; Wolmark, Norman

2013-12-20

Accurate assessments of recurrence risk and absolute treatment benefit are needed to inform colon cancer adjuvant therapy. The 12-gene Recurrence Score assay has been validated in patients with stage II colon cancer from the Cancer and Leukemia Group B 9581 and Quick and Simple and Reliable (QUASAR) trials. We conducted an independent, prospectively designed clinical validation study of Recurrence Score, with prespecified end points and analysis plan, in archival specimens from patients with stage II and III colon cancer randomly assigned to fluorouracil (FU) or FU plus oxaliplatin in National Surgical Adjuvant Breast and Bowel Project C-07. Recurrence Score was assessed in 892 fixed, paraffin-embedded tumor specimens (randomly selected 50% of patients with tissue). Data were analyzed by Cox regression adjusting for stage and treatment. Continuous Recurrence Score predicted recurrence (hazard ratio for a 25-unit increase in score, 1.96; 95% CI, 1.50 to 2.55; P < .001), as well as disease-free and overall survival (both P < .001). Recurrence Score predicted recurrence risk (P = .001) after adjustment for stage, mismatch repair, nodes examined, grade, and treatment. Recurrence Score did not have significant interaction with stage (P = .90) or age (P = .76). Relative benefit of oxaliplatin was similar across the range of Recurrence Score (interaction P = .48); accordingly, absolute benefit of oxaliplatin increased with higher scores, most notably in patients with stage II and IIIA/B disease. The 12-gene Recurrence Score predicts recurrence risk in stage II and stage III colon cancer and provides additional information beyond conventional clinical and pathologic factors. Incorporating Recurrence Score into the clinical context may better inform adjuvant therapy decisions in stage III as well as stage II colon cancer.

Validation of the 12-Gene Colon Cancer Recurrence Score in NSABP C-07 As a Predictor of Recurrence in Patients With Stage II and III Colon Cancer Treated With Fluorouracil and Leucovorin (FU/LV) and FU/LV Plus Oxaliplatin

PubMed Central

Yothers, Greg; O'Connell, Michael J.; Lee, Mark; Lopatin, Margarita; Clark-Langone, Kim M.; Millward, Carl; Paik, Soonmyung; Sharif, Saima; Shak, Steven; Wolmark, Norman

2013-01-01

Purpose Accurate assessments of recurrence risk and absolute treatment benefit are needed to inform colon cancer adjuvant therapy. The 12-gene Recurrence Score assay has been validated in patients with stage II colon cancer from the Cancer and Leukemia Group B 9581 and Quick and Simple and Reliable (QUASAR) trials. We conducted an independent, prospectively designed clinical validation study of Recurrence Score, with prespecified end points and analysis plan, in archival specimens from patients with stage II and III colon cancer randomly assigned to fluorouracil (FU) or FU plus oxaliplatin in National Surgical Adjuvant Breast and Bowel Project C-07. Methods Recurrence Score was assessed in 892 fixed, paraffin-embedded tumor specimens (randomly selected 50% of patients with tissue). Data were analyzed by Cox regression adjusting for stage and treatment. Results Continuous Recurrence Score predicted recurrence (hazard ratio for a 25-unit increase in score, 1.96; 95% CI, 1.50 to 2.55; P < .001), as well as disease-free and overall survival (both P < .001). Recurrence Score predicted recurrence risk (P = .001) after adjustment for stage, mismatch repair, nodes examined, grade, and treatment. Recurrence Score did not have significant interaction with stage (P = .90) or age (P = .76). Relative benefit of oxaliplatin was similar across the range of Recurrence Score (interaction P = .48); accordingly, absolute benefit of oxaliplatin increased with higher scores, most notably in patients with stage II and IIIA/B disease. Conclusion The 12-gene Recurrence Score predicts recurrence risk in stage II and stage III colon cancer and provides additional information beyond conventional clinical and pathologic factors. Incorporating Recurrence Score into the clinical context may better inform adjuvant therapy decisions in stage III as well as stage II colon cancer. PMID:24220557

Dislocation mechanism based model for stage II fatigue crack propagation rate

NASA Technical Reports Server (NTRS)

Mazumdar, P. K.

1986-01-01

Repeated plastic deformation, which of course depends on dislocation mechanism, at or near the crack tip leads to the fatigue crack propagation. By involving the theory of thermally activated flow and the cumulative plastic strain criterion, an effort is made here to model the stage II fatigue crack propagation rate in terms of the dislocation mechanism. The model, therefore, provides capability to ascertain: (1) the dislocation mechanism (and hence the near crack tip microstructures) assisting the crack growth, (2) the relative resistance of dislocation mechanisms to the crack growth, and (3) the fracture surface characteristics and its interpretation in terms of the dislocation mechanism. The local microstructure predicted for the room temperature crack growth in copper by this model is in good agreement with the experimental results taken from the literature. With regard to the relative stability of such dislocation mechanisms as the cross-slip and the dislocation intersection, the model suggests an enhancement of crack growth rate with an ease of cross-slip which in general promotes dislocation cell formation and is common in material which has high stacking fault energy (produces wavy slips). Cross-slip apparently enhances crack growth rate by promoting slip irreversibility and fracture surface brittleness to a greater degree.

Prognostic Impact of Erythropoietin Expression and Erythropoietin Receptor Expression on Locoregional Control and Survival of Patients Irradiated for Stage II/III Non-Small-Cell Lung Cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rades, Dirk, E-mail: Rades.Dirk@gmx.ne; Setter, Cornelia; Dahl, Olav

Purpose: Prognostic factors can guide the physician in selecting the optimal treatment for an individual patient. This study investigates the prognostic value of erythropoietin (EPO) and EPO receptor (EPO-R) expression of tumor cells for locoregional control and survival in non-small-cell lung cancer (NSCLC) patients. Methods and Materials: Fourteen factors were investigated in 62 patients irradiated for stage II/III NSCLC, as follows: age, gender, Karnofsky performance score (KPS), histology, grading, TNM/American Joint Committee on Cancer (AJCC) stage, surgery, chemotherapy, pack years (average number of packages of cigarettes smoked per day multiplied by the number of years smoked), smoking during radiotherapy, hemoglobinmore » levels during radiotherapy, EPO expression, and EPO-R expression. Additionally, patients with tumors expressing both EPO and EPO-R were compared to those expressing either EPO or EPO-R and to those expressing neither EPO nor EPO-R. Results: On univariate analysis, improved locoregional control was associated with AJCC stage II cancer (p < 0.048), surgery (p < 0.042), no smoking during radiotherapy (p = 0.024), and no EPO expression (p = 0.001). A trend was observed for a KPS of >70 (p = 0.08), an N stage of 0 to 1 (p = 0.07), and no EPO-R expression (p = 0.10). On multivariate analysis, AJCC stage II and no EPO expression remained significant. No smoking during radiotherapy was almost significant. On univariate analysis, improved survival was associated with N stage 0 to 1 (p = 0.009), surgery (p = 0.039), hemoglobin levels of {>=}12 g/d (p = 0.016), and no EPO expression (p = 0.001). On multivariate analysis, N stage 0 to 1 and no EPO expression maintained significance. Hemoglobin levels of {>=}12 g/d were almost significant. On subgroup analyses, patients with tumors expressing both EPO and EPO-R had worse outcomes than those expressing either EPO or EPO-R and those expressing neither EPO nor RPO-R. Conclusions: EPO expression of

Three Orbital Burns to Molniya Orbit Via Shuttle_Centaur G Upper Stage

NASA Technical Reports Server (NTRS)

Williams, Craig H.

2015-01-01

An unclassified analytical trajectory design, performance, and mission study was done for the 1982 to 1986 joint National Aeronautics and Space Administration (NASA)-United States Air Force (USAF) Shuttle/Centaur G upper stage development program to send performance-demanding payloads to high orbits such as Molniya using an unconventional orbit transfer. This optimized three orbital burn transfer to Molniya orbit was compared to the then-baselined two burn transfer. The results of the three dimensional trajectory optimization performed include powered phase steering data and coast phase orbital element data. Time derivatives of the orbital elements as functions of thrust components were evaluated and used to explain the optimization's solution. Vehicle performance as a function of parking orbit inclination was given. Performance and orbital element data was provided for launch windows as functions of launch time. Ground track data was given for all burns and coasts including variation within the launch window. It was found that a Centaur with fully loaded propellant tanks could be flown from a 37 deg inclination low Earth parking orbit and achieve Molniya orbit with comparable performance to the baselined transfer which started from a 57 deg inclined orbit: 9,545 versus 9,552 lb of separated spacecraft weight, respectively. There was a significant reduction in the need for propellant launch time reserve for a 1 hr window: only 78 lb for the three burn transfer versus 320 lb for the two burn transfer. Conversely, this also meant that longer launch windows over more orbital revolutions could be done for the same amount of propellant reserve. There was no practical difference in ground tracking station or airborne assets needed to secure telemetric data, even though the geometric locations of the burns varied considerably. There was a significant adverse increase in total mission elapsed time for the three versus two burn transfer (12 vs. 1-1/4 hr), but could be

Three Orbital Burns to Molniya Orbit via Shuttle Centaur G Upper Stage

NASA Technical Reports Server (NTRS)

Williams, Craig H.

2014-01-01

An unclassified analytical trajectory design, performance, and mission study was done for the 1982-86 joint NASA-USAF Shuttle/Centaur G upper stage development program to send performance-demanding payloads to high orbits such as Molniya using an unconventional orbit transfer. This optimized three orbital burn transfer to Molniya orbit was compared to the then-baselined two burn transfer. The results of the three dimensional trajectory optimization performed include powered phase steering data and coast phase orbital element data. Time derivatives of the orbital elements as functions of thrust components were evaluated and used to explain the optimization's solution. Vehicle performance as a function of parking orbit inclination was given. Performance and orbital element data was provided for launch windows as functions of launch time. Ground track data was given for all burns and coasts including variation within the launch window. It was found that a Centaur with fully loaded propellant tanks could be flown from a 37deg inclination low Earth parking orbit and achieve Molniya orbit with comparable performance to the baselined transfer which started from a 57deg inclined orbit: 9,545 lb vs. 9,552 lb of separated spacecraft weight respectively. There was a significant reduction in the need for propellant launch time reserve for a one hour window: only 78 lb for the three burn transfer vs. 320 lb for the two burn transfer. Conversely, this also meant that longer launch windows over more orbital revolutions could be done for the same amount of propellant reserve. There was no practical difference in ground tracking station or airborne assets needed to secure telemetric data, even though the geometric locations of the burns varied considerably. There was a significant adverse increase in total mission elapsed time for the three vs. two burn transfer (12 vs. 11/4 hrs), but could be accommodated by modest modifications to Centaur systems. Future applications were

Biomechanical Analysis of Cuboid Osteotomy Lateral Column Lengthening for Stage II B Adult-Acquired Flatfoot Deformity: A Cadaveric Study

PubMed Central

Zhou, Haichao; Ren, Haoyang; Li, Chunguang; Xia, Jiang; Yu, Guangrong

2017-01-01

Purpose. To investigate the effect of cuboid osteotomy lateral column lengthening (LCL) for the correction of stage II B adult-acquired flatfoot deformity in cadaver. Methods. Six cadaver specimens were loaded to 350 N. Flatfoot models were established and each was evaluated radiographically and pedobarographically in the following conditions: (1) intact foot, (2) flatfoot, and (3) cuboid osteotomy LCL (2, 3, 4, and 5 mm). Results. Compared with the flatfoot model, the LCLs showed significant correction of talonavicular coverage on anteroposterior radiographs and talus-first metatarsal angle on both anteroposterior and lateral radiographs (p < .05). Compared with the intact foot, the above angles of the LCLs showed no significant difference except the 2 mm LCL. In terms of forefoot pressure, medial pressure of the 2 mm LCL (p = .044) and lateral pressure of the 3, 4, and 5 mm LCLs showed statistical differences (p < .05), but lateral pressure of the 3 mm LCL was not more than the intact foot as compared to the 4 and 5 mm LCLs, which was less than medial pressure. Conclusion. Cuboid osteotomy LCL procedure avoids damage to subtalar joint and has a good effect on correction of stage II B adult-acquired flatfoot deformity with a 3 mm lengthening in cadavers. PMID:28497049

Evaluation of the dosimetric impact of applying flattening filter-free beams in intensity-modulated radiotherapy for early-stage upper thoracic carcinoma of oesophagus

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zhang, Wuzhe; Lin, Zhixiong; Yang, Zhining

2015-06-15

Flattening filter-free (FFF) radiation beams have recently become clinically available on modern linear accelerators in radiation therapy. This study aimed to evaluate the dosimetric impact of using FFF beams in intensity-modulated radiotherapy (IMRT) for early-stage upper thoracic oesophageal cancer. Eleven patients with primary stage upper thoracic oesophageal cancer were recruited. For each patient, two IMRT plans were computed using conventional beams (Con-P) and FFF beams (FFF-P), respectively. Both plans employed a five-beam arrangement and were prescribed with 64 Gy to (planning target volume) PTV1 and 54 Gy to PTV2 in 32 fractions using 6 MV photons. The dose parameters ofmore » the target volumes and organs at risks (OARs), and treatment parameters including the monitor units (MU) and treatment time (TT) for Con-P and FFF-P were recorded and compared. The mean D{sub 5} of PTV1 and PTV2 were higher in FFF-P than Con-P by 0.4 Gy and 0.3 Gy, respectively. For the OARs, all the dose parameters did not show significant difference between the two plans except the mean V{sub 5} and V{sub 10} of the lung in which the FFF-P was lower (46.7% vs. 47.3% and 39.1% vs. 39.6%, respectively). FFF-P required 54% more MU but 18.4% less irradiation time when compared to Con-P. The target volume and OARs dose distributions between the two plans were comparable. However, FFF-P was more effective in sparing the lung from low dose and reduced the mean TT compared with Con-P. Long-term clinical studies are suggested to evaluate the radiobiological effects of FFF beams.« less

Tissue expansion in the treatment of giant congenital melanocytic nevi of the upper extremity

PubMed Central

Ma, Tengxiao; Fan, Ke; Li, Lei; Xie, Feng; Li, Hao; Chou, Haiyan; Zhang, Zhengwen

2017-01-01

Abstract The aim of our study was to use tissue expansion for the treatment of giant congenital melanocytic nevi of the upper extremity and examine potential advantages over traditional techniques. There were 3 stages in the treatment of giant congenital melanocytic nevi of the upper extremities using tissue expansion: first, the expander was inserted into the subcutaneous pocket; second, the expander was removed, lesions were excised, and the wound of the upper extremity was placed into the pocket to delay healing; third, the residual lesion was excised and the pedicle was removed. The pedicle flap was then unfolded to resurface the wound. During the period between June 2007 and December 2015, there were 11 patients with giant congenital melanocytic nevi of the upper extremities who underwent reconstruction at our department with skin expansion. Few complications were noted in each stage of treatment. The functional and aesthetic results were observed and discussed in this study. Optimal aesthetic and functional results were obtained using tissue expansion to reconstruct the upper extremities due to the giant congenital melanocytic nevi. PMID:28353563

Are Upper-Body Axial Symptoms a Feature of Early Parkinson’s Disease?

PubMed Central

Moreau, Caroline; Baille, Guillaume; Delval, Arnaud; Tard, Céline; Perez, Thierry; Danel-Buhl, Nicolas; Seguy, David; Labreuche, Julien; Duhamel, Alain; Delliaux, Marie; Dujardin, Kathy; Defebvre, Luc

2016-01-01

Background Axial disorders are considered to appear late in the course of Parkinson’s disease (PD). The associated impact on quality of life (QoL) and survival and the lack of an effective treatment mean that understanding and treating axial disorders is a key challenge. However, upper-body axial disorders (namely dysarthria, swallowing and breathing disorders) have never been prospectively assessed in early-stage PD patients. Objectives To characterize upper-body axial symptoms and QoL in consecutive patients with early-stage PD. Methods We prospectively enrolled 66 consecutive patients with early-stage PD (less than 3 years of disease progression) and assessed dysarthria, dysphagia and respiratory function (relative to 36 controls) using both objective and patient-reported outcomes. Results The mean disease duration was 1.26 years and the mean UPDRS motor score was 19.4 out of 108. 74% of the patients presented slight dysarthria (primarily dysprosodia). Men appeared to be more severely affected (i.e. dysphonia). This dysfunction was strongly correlated with low swallowing speed (despite the absence of complaints about dysphagia), respiratory insufficiency and poor QoL. Videofluorography showed that oral-phase swallowing disorders affected 60% of the 31 tested patients and that pharyngeal-phase disorders affected 21%. 24% of the patients reported occasional dyspnea, which was correlated with anxiety in women but not in men. Marked diaphragmatic dysfunction was suspected in 42% of the patients (predominantly in men). Conclusion Upper body axial symptoms were frequent in men with early-stage PD, whereas women presented worst non-motor impairments. New assessment methods are required because currently available tools do not reliably detect these upper-body axial disorders. PMID:27654040

Modeling and Test Data Analysis of a Tank Rapid Chill and Fill System for the Advanced Shuttle Upper Stage (ASUS) Concept

NASA Technical Reports Server (NTRS)

Flachbart, Robin; Hedayat, Ali; Holt, Kimberly A.; Cruit, Wendy (Technical Monitor)

2001-01-01

The Advanced Shuttle Upper Stage (ASUS) concept addresses safety concerns associated .with cryogenic stages by launching empty, and filling on ascent. The ASUS employs a rapid chill and fill concept. A spray bar is used to completely chill the tank before fill, allowing the vent valve to be closed during the fill process. The first tests of this concept, using a flight size (not flight weight) tank. were conducted at Marshall Space Flight Center (MSFC) during the summer of 2000. The objectives of the testing were to: 1) demonstrate that a flight size tank could be filled in roughly 5 minutes to accommodate the shuttle ascent window, and 2) demonstrate a no-vent fill of the tank. A total of 12 tests were conducted. Models of the test facility fill and vent systems, as well as the tank, were constructed. The objective of achieving tank fill in 5 minutes was met during the test series. However, liquid began to accumulate in the tank before it was chilled. Since the tank was not chilled until the end of each test, vent valve closure during fill was not possible. Even though the chill and fill process did not occur as expected, reasonable model correlation with the test data was achieved.

Urothelial carcinoma of the bladder and the upper tract: disparate twins.

PubMed

Green, David A; Rink, Michael; Xylinas, Evanguelos; Matin, Surena F; Stenzl, Arnulf; Roupret, Morgan; Karakiewicz, Pierre I; Scherr, Douglas S; Shariat, Shahrokh F

2013-04-01

Urothelial carcinoma of the bladder is the 4th most common malignancy in men and the 8th most common cause of male cancer death in the United States. Conversely, upper tract urothelial carcinoma accounts for only 5% to 10% of all urothelial carcinoma. Due to the relative preponderance of urothelial carcinoma of the bladder, much of the clinical decision making regarding upper tract urothelial carcinoma is extrapolated from evidence that is based on urothelial carcinoma of the bladder cohorts. In fact, only 1 major urological organization has treatment guidelines specific for upper tract urothelial carcinoma. While significant similarities exist between these 2 diseases, ignoring the important differences may be preventing us from optimizing therapy in patients with upper tract urothelial carcinoma. Therefore, we explored these dissimilarities, including the differential importance of gender, anatomy, staging, intracavitary therapy, surgical lymphadenectomy and perioperative systemic chemotherapy on the behavior of urothelial carcinoma of the bladder and upper tract urothelial carcinoma. A nonsystematic literature search using the MEDLINE/PubMed® database was conducted to identify original articles, review articles and editorials. Searches were limited to the English language and studies in humans and in adults, and used the key words urothelial carcinoma, upper tract urothelial carcinoma or transitional cell carcinoma combined with several different sets of key words to identify appropriate publications for each section of the manuscript. The key words, broken down by section, were 1) epidemiology, sex, gender; 2) location, tumor location; 3) staging, stage; 4) intracavitary, intravesical, topical therapy; 5) lymphadenectomy, lymph node, lymph node dissection and 6) adjuvant, neoadjuvant, chemotherapy. Women who present with urothelial carcinoma of the bladder do so with less favorable tumor characteristics and have worse survival than men. However, gender does

Simulations of the Mg II K and Ca II 8542 Lines From an Alfvén Wave-Heated Flare Chromosphere

NASA Technical Reports Server (NTRS)

Kerr, Graham S.; Fletcher, Lyndsay; Russell, Alexander J. B.; Allred, Joel C.

2016-01-01

We use radiation hydrodynamic simulations to examine two models of solar flare chromospheric heating: Alfven wave dissipation and electron beam collisional losses. Both mechanisms are capable of strong chromospheric heating, and we show that the distinctive atmospheric evolution in the mid-to-upper chromosphere results in Mg II k-line emission that should be observably different between wave-heated and beam-heated simulations. We also present Ca II 8542 A profiles that are formed slightly deeper in the chromosphere. The Mg II k-line profiles from our wave-heated simulation are quite different from those from a beam-heated model and are more consistent with Interface Region Imaging Spectrograph observations. The predicted differences between the Ca II 8542 A in the two models are small. We conclude that careful observational and theoretical study of lines formed in the mid-to-upper chromosphere holds genuine promise for distinguishing between competing models for chromospheric heating inflares.

[High-dose Crataegus extract WS 1442 in the treatment of NYHA stage II heart failure].

PubMed

Tauchert, M; Gildor, A; Lipinski, J

1999-10-01

The efficacy and tolerance of the standardized hawthorn (crataegus) extract WS 1442 were tested in a multicenter utilization observational study. We monitored 1,011 patients with cardiac insufficiency stage NYHA II, treated with this extract (Crataegutt novo 450, 1 tablet b.i.d.) over a period of 24 weeks. During and at the end of the observation period a significant improvement in clinical symptoms (reduced performance in the exercise tolerance test, fatigue, palpitation and exercise dyspnea) was observed. Ankle edema and nocturia disappeared by 83%, and by half of the patients respectively manifesting these symptoms before treatment. The improvement and economization of cardiac performance were additionally shown by a reduction in blood pressure, an increased maximal exercise tolerance and a reduction in the difference in the pressure/heart rate product (PHRP). The positive effects of WS 1442 were further demonstrated by an improved ejection fraction and an increased percentile shortening fraction measured using M-mode echocardiography. The stabilizing effect of the hawthorn extract on the heart rate was shown by a slower rest pulse, as well as by an increase in the number of day and night normorhythmic patients, as documented by long-term ECG. The reduction in the number of patients showing ST depressions, arrhythmias and ventricular extrasystoles at the maximum exercise level is regarded as an indication for an improved myocardial perfusion. Fourteen side effects were noted. In two cases (abdominal discomfort and facial pains accompanied by tachycardia) a possible relationship with the hawthorn therapy, was postulated which however was considered unlikely by the treating physicians. Almost 2/3 of the patients felt better or much better following the 24 weeks of treatment. More than 3/4 of the participating physicians noted a good or a very good efficacy, and 98.7% noted a good or a very good tolerance. High-dose hawthorn therapy is an efficient, well

Orion Stage Adapter Arrival

NASA Image and Video Library

2018-04-03

NASA's Super Guppy aircraft taxies onto the tarmac after touching down at the Shuttle Landing Facility at the agency's Kennedy Space Center in Florida. The Super Guppy is carrying the Orion Stage Adapter (OSA), the second flight-hardware section of NASA's Space Launch System (SLS) rocket that has arrived at Kennedy. The OSA will connect the Orion spacecraft to the upper part of the SLS rocket, the interim cryogenic propulsion stage (ICPS). Both the OSA and ICPS are being stored for processing in the center's Space Station Processing Facility in preparation for Exploration Mission-1, the first uncrewed, integrated launch of the SLS rocket and Orion spacecraft.

Orion Stage Adapter Arrival

NASA Image and Video Library

2018-04-03

NASA's Super Guppy aircraft glides to a stop at the Shuttle Landing Facility at the agency's Kennedy Space Center in Florida. The Super Guppy is carrying the Orion Stage Adapter (OSA), the second flight-hardware section of NASA's Space Launch System (SLS) rocket that has arrived at Kennedy. The OSA will connect the Orion spacecraft to the upper part of the SLS rocket, the interim cryogenic propulsion stage (ICPS). Both the OSA and ICPS are being stored for processing in the center's Space Station Processing Facility in preparation for Exploration Mission-1, the first uncrewed, integrated launch of the SLS rocket and Orion spacecraft.

Orion Stage Adapter Arrival

NASA Image and Video Library

2018-04-03

NASA's Super Guppy aircraft prepares to touch down at the Shuttle Landing Facility at the agency's Kennedy Space Center in Florida. The Super Guppy is carrying the Orion Stage Adapter (OSA), the second flight-hardware section of NASA's Space Launch System (SLS) rocket that has arrived at Kennedy. The OSA will connect the Orion spacecraft to the upper part of the SLS rocket, the interim cryogenic propulsion stage (ICPS). Both the OSA and ICPS are being stored for processing in the center's Space Station Processing Facility in preparation for Exploration Mission-1, the first uncrewed, integrated launch of the SLS rocket and Orion spacecraft.

Preoperative high-resolution magnetic resonance imaging can identify good prognosis stage I, II, and III rectal cancer best managed by surgery alone: a prospective, multicenter, European study.

PubMed

Taylor, Fiona G M; Quirke, Philip; Heald, Richard J; Moran, Brendan; Blomqvist, Lennart; Swift, Ian; Sebag-Montefiore, David J; Tekkis, Paris; Brown, Gina

2011-04-01

To assess local recurrence, disease-free survival, and overall survival in magnetic resonance imaging (MRI)-predicted good prognosis tumors treated by surgery alone. The MERCURY study reported that high-resolution MRI can accurately stage rectal cancer. The routine policy in most centers involved in the MERCURY study was primary surgery alone in MRI-predicted stage II or less and in MRI "good prognosis" stage III with selective avoidance of neoadjuvant therapy. Data were collected prospectively on all patients included in the MERCURY study who were staged as MRI-defined "good" prognosis tumors. "Good" prognosis included MRI-predicted safe circumferential resection margins, with MRI-predicted T2/T3a/T3b (less than 5 mm spread from muscularis propria), regardless of MRI N stage. None received preoperative or postoperative radiotherapy. Overall survival, disease-free survival, and local recurrence were calculated. Of 374 patients followed up in the MERCURY study, 122 (33%) were defined as "good prognosis" stage III or less on MRI. Overall and disease-free survival for all patients with MRI "good prognosis" stage I, II and III disease at 5 years was 68% and 85%, respectively. The local recurrence rate for this series of patients predicted to have a good prognosis tumor on MRI was 3%. The preoperative identification of good prognosis tumors using MRI will allow stratification of patients and better targeting of preoperative therapy. This study confirms the ability of MRI to select patients who are likely to have a good outcome with primary surgery alone.

Prognostic relevance of biological subtype overrides that of TNM staging in breast cancer: discordance between stage and biology.

PubMed

Jung, Hyun Ae; Park, Yeon Hee; Kim, Moonjin; Kim, Sungmin; Chang, Won Jin; Choi, Moon Ki; Hong, Jung Yong; Kim, Seok Won; Kil, Won Ho; Lee, Jeong Eon; Nam, Seok Jin; Ahn, Jin Seok; Im, Young-Hyuck

2015-02-01

Recently, we faced difficult treatment decisions regarding appropriate adjuvant systemic treatment, especially for patients who show discordance between stage and tumor biology. The aim of this study was to compare the prognostic relevance of the TNM staging system with that of intrinsic subtype in breast cancer. We retrospectively identified women patients who received curative surgery for stage I-III breast cancer with available data on immunohistochemistry profiles including hormone receptor (HR) status, human epidermal growth factor receptor 2 (HER2) status, and Ki 67 staining at the Samsung Medical Center from January 2004 to September 2008. Primary outcomes were recurrence-free survival (RFS) and overall survival (OS). A total of 1145 patients were diagnosed with breast cancer and received curative surgery. Of these, 463 (40.4%) patients were stage I, and 682 (59.6%) were stage II or III. In addition, 701 (61.2%) patients were HR positive, 239 (20.9%) were HER2 positive, and 205 (20.9%) had triple-negative breast cancer. The 5-year RFS for the patients who were HR positive and HER2 negative with a low Ki 67 staining score (0-25%) was 99%. The 5-year RFS for patients who were HER2-positive or had triple-negative breast cancer were 89 and 83%, respectively (P value = <0.001). In multivariate analysis, advanced stage (II/III) and unfavorable biology (HER2 positive or triple negative) retained their statistical significance as predictors of decreased RFS and OS. Patients with advanced-stage disease (II or III) but favorable tumor biology (HR positive and HER2 negative and low Ki 67) had better clinical outcomes than those with stage I disease and unfavorable tumor biology in terms of RFS (99 versus 92%, P value = 0.011) and OS (99 versus 96%, P value = 0.03) at 5 years. The current results showed that intrinsic subtype has a greater prognostic impact in predicting clinical outcomes in subpopulations of patients with stage I-III breast cancer who show