Strong spatial variation of rupture characteristics in the moment magnitude (M(w)) 9.0 Tohoku-Oki megathrust earthquake controlled both the strength of shaking and the size of the tsunami that ...followed. Finite-source imaging reveals that the rupture consisted of a small initial phase, deep rupture for up to 40 seconds, extensive shallow rupture at 60 to 70 seconds, and continuing deep rupture lasting more than 100 seconds. A combination of a shallow dipping fault and a compliant hanging wall may have enabled large shallow slip near the trench. Normal faulting aftershocks in the area of high slip suggest dynamic overshoot on the fault. Despite prodigious total slip, shallower parts of the rupture weakly radiated at high frequencies, whereas deeper parts of the rupture radiated strongly at high frequencies.
Novel treatment strategies are needed for older patients with acute myeloid leukemia (AML). This randomized phase 2 trial compared the efficacy and safety of 20 mg/m2 of IV decitabine on days 1 to 10 ...alone (arm A) with those of 1.3 mg/m2 of subcutaneous bortezomib (arm B) on days 1, 4, 8, and 11 for up to 4 10-day cycles followed by monthly 5-day cycles. Previously untreated AML patients age ≥60 years (excluding those with FLT3 mutations and favorable-risk cytogenetics) without restrictions in performance status (PS) or organ function were eligible. Median age was 72.4 years (range, 60.5-92.3 years); 31 patients (19%) had baseline PS ≥2, 35 (22%) had an antecedent hematological disorder, 58 had (39%) adverse cytogenetics, and 7 (5%) and 23 (14%) had abnormal cardiac or renal function. There were no statistically significant differences in overall survival (OS) or responses between the 2 treatment arms. The overall response rate (complete remission + complete remission with incomplete blood count recovery) was 39% (n = 64), with median OS of 9.3 months. Nineteen responders (31%) underwent allogeneic stem cell transplantation. The most common adverse event was febrile neutropenia, and there were no unexpected toxicities. Adding bortezomib to decitabine did not improve outcomes, but responses were better than those in previous trials using 5-day decitabine cycles. This trial was registered at www.clinicaltrials.gov as #NCT01420926.
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Previous data suggest that the immune microenvironment plays a critical role in human epidermal growth factor receptor 2 (HER2) -positive breast cancer; however, there is little known about the ...immune profiles of small HER2-positive tumors. In this study, we aimed to characterize the immune microenvironment of small HER2-positive breast cancers included in the Adjuvant paclitaxel and trastuzumab for node-negative, HER2-positive breast cancer (APT) trial and to correlate the immune markers with pathological and molecular tumor characteristics.
The APT trial was a multicenter, single-arm, phase II study of paclitaxel and trastuzumab in patients with node-negative HER2-positive breast cancer. The study included 406 patients with HER2-positive, node-negative breast cancer, measuring up to 3cm. Exploratory analysis of tumor infiltrating lymphocytes (TIL), programmed death-ligand 1 (PD-L1) expression (by immunohistochemistry), and immune gene signatures using data generated by nCounter PanCancer Pathways Panel (NanoString Technologies, Seattle, WA), and their association with pathological and molecular characteristics was carried out.
Of the 406 patients, 328 (81%) had at least one immune assay carried out: 284 cases were evaluated for TIL, 266 for PD-L1, and 213 for immune gene signatures. High TIL (≥60%) were seen with greater frequency in hormone-receptor (HR) negative, histological grades 2 and 3, as well in HER2-enriched and basal-like tumors. Lower stromal PD-L1 (≤1%) expression was seen with greater frequency in HR-positive, histological grade 1, and in luminal tumors. Both TIL and stromal PD-L1 were positively correlated with 10 immune cell signatures, including Th1 and B cell signatures. Luminal B tumors were negatively correlated with those signatures. Significant correlation was seen among these immune markers; however, the magnitude of correlation did not indicate a monotonic relationship between them.
Immune profiles of small HER2-positive breast cancers differ according to HR status, histological grade, and molecular subtype. Further work is needed to explore the implication of these findings on disease outcome.
clinicaltrials.gov identifier: NCT00542451.
A 64-year-old woman with the diagnosis of acute anterior infarction was treated with streptokinase, i.v. heparin, and aspirin. After 20 hours of hospitalization she developed hypotension and a fall ...in hematocrit level with acute onset of severe abdominal pain. After genitourinary and gastrointestinal bleeding, pulmonary embolism and reinfarction had been ruled out, however, abdominal ultrasonography revealed intraabdominal hemorrhage and the patient was given three units of blood transfusion. Abdominal laparotomy and laparoscopy were not performed as the patient's clinical status stabilized on the 3rd day and hemodynamics did not deteriorate thereafter. Abdominal computerized tomography in the second week revealed a splenic rupture.
In recent years significant studies have been initiated on the feasibility of utilizing a portion of the 3 km S-band accelerator at SLAC to drive a short wavelength (4.5−1.5 Å) Linac Coherent Light ...Source (LCLS), a Free-Electron Laser (FEL) operating in the Self-Amplified Spontaneous Emission (SASE) regime. Electron beam requirements for single-pass saturation in a minimal time include: 1) a peak current in the 7 kA range, 2) a relative energy spread of <0.05%, and 3) a transverse emittance, ε rad-m, approximating the diffraction-limit condition
ε =
λ
4π
, where λm is the output wavelength. Requirements on the insertion device include field error levels of 0.02% for keeping the electron bunch centered on and in phase with the amplified photons, and a focusing beta of 8 m/rad for inhibiting the dilution of its transverse density. Although much progress has been made in developing individual components and beam-processing techniques necessary for LCLS operation down to ∼20 Å, a substantial amount of research and development is still required in a number of theoretical and experimental areas leading to the construction and operation of a 4.5−1.5 Å LCLS. In this paper we report on a research and development program underway and in planning at SLAC for addressing critical questions in these areas. These include the construction and operation of a linac test stand for developing laser-driven photocathode rf guns with normalized emittances approaching 1 mm-mrad; development of advanced beam compression, stability, and emittance control techniques at multi-GeV energies; the construction and operation of a FEL Amplifier Test Experiment (FATE) for theoretical and experimental studies of SASE at IR wavelengths; an undulator development program to investigate superconducting, hybrid/permanent magnet (hybrid/PM), and pulsed-Cu technologies; theoretical and computational studies of high-gain FEL physics and LCLS component designs; development of X-ray optics and instrumentation for extracting, modulating, and delivering photons to experimental users; and the study and development of scientific experiments made possible by the source properties of the LCLS.
The implementation of the Fetal and Infant Mortality Review (FIMR) process was examined as part of the evaluation of the national Healthy Start program, a federal program designed to reduce infant ...mortality in several communities. The implementation of the FIMR process over the 5-year funding period is described in terms of productivity, barriers and facilitators to implementation, and project expenditures.
Data were derived from grant continuation applications and personal interviews with program staff to produce a qualitative description.
As of the summer of 1996, 14 of the 15 Healthy Start sites in the national evaluation had successfully implemented the FIMR process. Most sites had developed a two-tiered review process for examination of case data in which a review by health and social services professionals was followed by community review. In the period 1993 to 1995, the percentage of fetal and infant deaths reviewed had a median of 34% with a range of 4-79% across the sites at a cost of $600 to $3400 per death reviewed. Recommendations were variably implemented.
The FIMR process provides an important opportunity to contribute to the knowledge base regarding infant mortality in these communities. The process, however, has important logistical requirements and may require substantial financial resources that may affect implementation of confidential inquiries into infant mortality and other health problems.
The booster synchrotron for the recently commissioned Stanford Synchrotron Radiation Laboratory (SSRL) injector facility employs a 10 Hz resonant magnet power supply system, or White circuit, as ...described by M.G. White et al. (1956), to accelerate an electron beam from 120 MeV to 3 GeV. Four major design specifications were required to establish the basic White circuit network: (1) the operating frequency; (2) the method of powering the quadrupoles; (3) the number of resonant cells and their configuration; and (4) the DC and AC power supply configuration. The booster dipole and quadrupole magnets are connected in series within a system of 17 distributed resonant cells driven by a pulsing network. Tracking power supplies driving the trim coils of the two quadrupole families are used to stabilize betatron tunes during energy ramping. The White circuit has proven to be a reliable and relatively simple system to operate during its several months of 2.35 GeV operation.< >
A 120 MeV, 2856 MHz, traveling wave linear accelerator (linac), with a microwave gun, alpha magnet, and chopper, has been built at the Stanford Synchrotron Radiation Laboratory (SSRL) as a ...preinjector for and along with a 3 GeV, 358.54 MHz, booster synchrotron ring. The resulting injector will be available on demand to fill the Stanford Positron-Electron Accelerator Ring (SPEAR), which is a storage ring now dedicated to synchrotron light production. A description is given of the injector's two separate and different frequency RF systems. Synchronization of the two, non-harmonic systems is achieved through the linac's chopper. Some of the interesting mechanical and electrical details are discussed and the operating characteristics of the linac and ring RF are highlighted.< >
The 3 GeV synchrotron injector for SPEAR Weidemann, H.; Baltay, M.; Voss, J. ...
Conference Record of the 1991 IEEE Particle Accelerator Conference,
1991
Conference Proceeding
A dedicated 3-GeV injector synchrotron for the storage ring SPEAR has been constructed at the Stanford Synchrotron Radiation Laboratory, SSRL. The injector consists of an RF-gun, a 120-MeV linear ...accelerator, a 3-GeV booster synchrotron, and associated beam transport lines. General design features and special new developments for this injector are presented, together with operational performance.< >
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