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Temperature is a complicated thermodynamic parameter to measure in dynamic compression experiments. Optical pyrometry is a general-purpose "work-horse" technique for measuring temperature from a radiant surface on these experimental platforms. The optical pyrometry channels are commonly held to the visible or Near-Infrared spectrum, which provides high fidelity temperature measurement for shock temperature above ∼1200-1500 K. However, low temperature (T < 1200 K) dynamic material experiments, including low pressure or quasi-isentropic studies, as well as experiments with complex thermodynamic paths, require Mid-Infrared (Mid-IR) for high fidelity measurements. This article outlines the design, testing, and characterization of a novel Mid-IR pyrometer system that can be configured between 2.5 and 5.0 µm, suitable for lower temperature measurements and for increasing the fidelity and precision of higher temperature measurements. Experimental validation was done on two separate gas gun platforms, with two separate impact velocities, achieving temperatures between 450 and 1100 K.

Corticosteroids are commonly used for the management of severe toxicities associated with chimeric antigen receptor (CAR) T-cell therapy. However, it remains unclear whether their dose, duration, and timing may affect clinical efficacy. Here, we determined the impact of corticosteroids on clinical outcomes in patients with relapsed or refractory large B-cell lymphoma treated with standard of care anti-CD19 CAR T-cell therapy. Among 100 patients evaluated, 60 (60%) received corticosteroids for management of CAR T-cell therapy-associated toxicities. The median cumulative dexamethasone-equivalent dose was 186 mg (range, 8-1803) and the median duration of corticosteroid treatment was 9 days (range, 1-30). Corticosteroid treatment was started between days 0 and 7 in 45 (75%) patients and beyond day 7 in 15 (25%). After a median follow-up of 10 months (95% confidence interval, 8-12 months), use of higher cumulative dose of corticosteroids was associated with significantly shorter progression-free survival. More importantly, higher cumulative dose of corticosteroids, and prolonged and early use after CAR T-cell infusion were associated with significantly shorter overall survival. These results suggest that corticosteroids should be used at the lowest dose and for the shortest duration and their initiation should be delayed whenever clinically feasible while managing CAR T-cell therapy-associated toxicities., (© 2021 by The American Society of Hematology.)

Neurotoxicity or immune effector cell-associated neurotoxicity syndrome (ICANS) is the second most common acute toxicity after chimeric antigen receptor (CAR) T-cell therapy. However, there are limited data on the clinical and radiologic correlates of ICANS. We conducted a cohort analysis of 100 consecutive patients with relapsed or refractory large B-cell lymphoma (LBCL) treated with standard of care axicabtagene ciloleucel (axi-cel). ICANS was graded according to an objective grading system. Neuroimaging studies and electroencephalograms (EEGs) were reviewed by an expert neuroradiologist and neurologist. Of 100 patients included in the study, 68 (68%) developed ICANS of any grade and 41 (41%) had grade ≥3. Median time to ICANS onset was 5 days, and median duration was 6 days. ICANS grade ≥3 was associated with high peak ferritin (P = .03) and C-reactive protein (P = .001) levels and a low peak monocyte count (P = .001) within the 30 days after axi-cel infusion. Magnetic resonance imaging was performed in 38 patients with ICANS and revealed 4 imaging patterns with features of encephalitis (n = 7), stroke (n = 3), leptomeningeal disease (n = 2), and posterior reversible encephalopathy syndrome (n = 2). Abnormalities noted on EEG included diffuse slowing (n = 49), epileptiform discharges (n = 6), and nonconvulsive status epilepticus (n = 8). Although reversible, grade ≥3 ICANS was associated with significantly shorter progression-free (P = .02) and overall survival (progression being the most common cause of death; P = .001). Our results suggest that imaging and EEG abnormalities are common in patients with ICANS, and high-grade ICANS is associated with worse outcome after CAR T-cell therapy in LBCL patients., (© 2020 by The American Society of Hematology.)

The impact of bridging therapy (BT) administered between leukapheresis and chimeric antigen receptor (CAR) T-cell therapy for large B-cell lymphoma (LBCL) is unclear. We evaluated the influence of BT (systemic therapy [ST], radiation therapy [RT], or combined-modality therapy [CMT]) on outcomes of 148 LBCL patients who underwent leukapheresis for planned axicabtagene ciloleucel (axi-cel) infusion. The 55% (n = 81) of patients who received BT were more likely to have international prognostic index (IPI) score ≥3 (P ≤ .01), bulky disease (P = .01), and elevated lactate dehydrogenase (LDH; P ≤ .01). The 1-year progression-free (PFS) and overall survival (OS) rates were 40% and 65% in non-BT patients vs 21% and 48% in BT patients (P = .01 and .05, respectively). Twenty-four patients (16%) did not receive axi-cel, most commonly because of lymphoma progression (88%), despite 80% (n = 19) receiving BT. Among 124 patients who received axi-cel, 50% (n = 62) received BT with ST (n = 45), RT (n = 11), or CMT (n = 6); 1-year PFS and OS rates were not significantly different between BT and non-BT cohorts (P = .06 and .21, respectively). There was no difference in proportion of patients with IPI ≥3, limited-stage disease, or elevated LDH between ST, RT, and CMT groups. Compared with non-BT patients, 1-year PFS was inferior for ST-bridged patients (P = .01). RT-bridged patients had improved PFS compared with ST-bridged patients (P = .05). Despite the poor prognosis associated with requiring BT, RT can be an effective bridging strategy. Future studies are necessary to identify strategies that may improve access to CAR T-cell therapy and outcomes., (© 2020 by The American Society of Hematology.)

Objectives: The aim of the study was to describe and assess the technical success and safety of ultrasound-guided liver biopsy with gelatin sponge pledget tract embolization technique in infants <10 kg across 3 tertiary pediatric hospitals., Materials and Methods: There were 67 pediatric patients weighing <10 kg (36 boys; 31 girls; average age 202 days; average weight 6 kg, range 1.5-9.9 kg) referred for liver biopsy performed with ultrasound guidance and gelatin sponge pledget tract embolization during a 2-year period. Patient history, procedural records, and clinical follow-up documents were retrospectively reviewed., Results: A total of 67 procedures were included. There was 100% technical success rate and all samples obtained provided adequate tissue for histological assessment. Average number of 18 G biopsy passes was 3 (range 1-6). There were no procedure-related deaths. There was 1 complication (1%) in a 5-kg infant who was readmitted 36 hours after biopsy with a fever and fully recovered after antibiotics were administered. Biliary atresia was the most common underlying diagnosis (20%), whereas others included acute rejection (16%) and biliary obstruction (7%)., Conclusions: Ultrasound-guided percutaneous liver biopsy with gelatin sponge pledget tract embolization technique in children weighing <10 kg is safe, effective, and use of this technique may lead to a reduction in rates of adverse events reported in other pediatric series.

Background: Custom carbon-fiber composite ankle foot orthoses (AFOs) have been anecdotally reported to improve gait of Charcot-Marie-Tooth (CMT) patients. The purpose of the study was to characterize the spatio-temporal, joint kinetic and mechanical responses of a custom carbon fiber AFO during locomotion for persons diagnosed with CMT., Methods: Eight volunteers were fitted with custom AFOs. Three of the devices were instrumented with eight strain gauges to measure surface deformation of the shell during dynamic function. Following a minimum 10 weeks accommodation period, plantar- and dorsiflexor strength was measured bilaterally. Volunteers then walked unbraced and braced, at their preferred pace over a force platform and instrumented walkway while being tracked with a 12-camera motion capture system. Strength, spatio-temporal and lower extremity joint kinetic parameters were evaluated between conditions (single subject) using the model statistic procedure. Mechanical loads were presented descriptively., Results: All participants walked faster (89.4 ± 13.3 vs 115.6 ± 18.0 cm/s) in the braced condition with ankle strength negatively correlated to speed increase. As Δ velocity increased, maximum joint moments during loading response shifted from the hip joint to the ankle and knee joints. During propulsion, the hip joint moment dominated. Subjects exhibiting the greatest and least Δ velocity imposed an average load of 54.6% and 16.6% of body weight on the braces, respectively. Energy storage in the brace averaged 9.6 ± 6.6J/kg., Conclusion: Subject-specific effects of a custom AFO on gait for CMT patients were documented. The force-deflection properties of carbon-fiber composite braces may be important considerations in their design., (Copyright © 2013 Elsevier B.V. All rights reserved.)

This article examines the delicate ideological maneuverings that shaped American colonial constructions of savagery, civility, and gender in the wake of the Bud Dajo massacre in the Philippines's Muslim south in 1906. It looks particularly at shifting notions of femininity and masculinity as these related to episodes of violence and colonial control. The article concludes that, while the Bud Dajo massacre was a terrible black mark on the American military's record in Mindanao and Sulu, colonial officials ultimately used the event to positively affirm existing discourses of power and justification, which helped to sustain and guide military rule in the Muslim south for another seven years.

There is limited research defining the minimally acceptable porcelain margin angle required to withstand the stresses incurred during seating a restoration. A mathematical model was derived to calculate this critical porcelain margin angle. The factors involved in margin fracture were determined to be the tensile strength of the porcelain, the axial reduction, the diameter of the tooth, the porcelain margin angle, and the seating force. As the seating force increases, the porcelain margin angle required to prevent failure also increases. Increasing either the axial reduction or the diameter of the tooth allowed the minimum porcelain margin angle to decrease.

This study was designed to measure the porcelain margin angles of completed collarless metal ceramic restorations and determine if these angles correspond to the most frequently recommended porcelain margin angle of 90 degrees. A sample of 99 metal ceramic restorations with porcelain labial margins were evaluated. A 1.0 mm slice taken from the midfacial impression of each restoration was evaluated by tooth location with a stereomaster microscope and the angle of the labial porcelain margin was calculated. The comparison of margin angles by tooth location showed no statistical difference between the groups. Comparison of the average margin angle with the most suggested 90-degree angle was analyzed with a One-Sample t-test and found to be statistically significant (p = 0.000). Although the majority of dental schools teach the shoulder preparation for collarless metal ceramic restorations, only 43% of the restorations measured fell within 10 degrees of this standard.

A needle system with a retractable barb was developed for localization of nonpalpable breast lesions. The system can be repositioned without major adjustments and strongly anchors to breast tissue, eliminating failure due to dislodgment or transection of the localizing wire. Its use may necessitate fewer confirmatory radiographs, resulting in decreased radiation exposure. In addition, the needle can be retracted during surgery, to ease extraction of the specimen.

The authors describe a new angiographic catheter, which delivers equal flow rates through the side holes and reduced flow through the end hole compared with conventional catheters. Computer analysis of catheter-flow models revealed that placement of larger side holes proximally and smaller side holes distally produces more uniform flow rates out of the holes. This decreases the risk of potentially hazardous delivery of high-pressure jets of contrast material from the end hole. The flow pattern is so uniform that it resembles a cloud of contrast material on injection. This catheter design is particularly applicable for 3-5-F catheters, which require high-pressure injections. Clinical testing in 50 cases revealed no extravasations or unintentional selective injections with use of this catheter.

A new coaxial exchange guide wire, which has a variable-length, flexible "J"-shaped tip for exchanging drainage catheters in both large and small structures, is described. The design provides a gradual transition from the softness of the tip to the stiffness of the cannula. The system is presently available in two sizes (0.89 mm [0.035 in.] and 0.64 mm [0.025 in.]) and can also be used as a catheter end-hole dilator.

A new-design basket for stone removal uses a standard Teflon catheter with radially positioned holes at its tip to hold either monofilament or soft wire. The strands are positioned to form a basket that will change in both size and shape simply by advancing or retracting these strands. This basket is much safer, can be changed in size during maneuvering , will transmit instruments for stone fragmentation, and can be advanced over a guide wire. It has been effective both in vitro and in the retrieval of biliary and urinary tract stones in 20 patients, several of which could not be retrieved by standard methods.

Pregnant and subsequently lactating rats had ad lib access to drinking water which contained either a benzodiazepine antagonist, Ro 15-1788 or diazepam (DZ). On the average, the rats consumed 2.9 mg/kg/day of Ro 15-1788 or 5.3 mg/kg/day of diazepam over the time period of 3 weeks, from gestation day 14 through postpartum day 14. The control group consumed equivalent volumes of the drug vehicle in water. While Ro 15-1788 had no apparent toxic effects, the numbers of viable pups in the DZ group were significantly reduced. The mean weight of the viable pups, and their gross behavior were not different in all three groups. However, the fully mature 4.5-month-old male progenies exposed to Ro 15-1788 were much more efficient in the radial arm maze test than the control or the diazepam-exposed animals; they rapidly habituated to the novel environment, their exploratory activity was uninhibited by distracting visual and auditory stimuli, they made fewer "working memory" errors in collecting baits, had a much better control over their emotional responses and the autonomic nervous system, as shown by very low defecation/urination scores, and, at the age of 5 months, they had a significant (66%) increase in the density of benzodiazepine receptors in the hippocampal formation, as compared to the control or the diazepam-exposed progenies. In conclusion, the upregulation of benzodiazepine receptor ontogenesis is retained in adult animals and resulted in improved "working memory" and better control over emotional responses that were particularly evident when the animals were challenged by novel and "intimidating" environmental stimuli.

The "accordion" catheter was developed as an adjunct to the Hawkins needle guide to provide safe single-step percutaneous drainage. The Hawkins needle guide is a long, 22-gauge "skinny" needle-cannula system that can be used like any other skinny needle. It can also be used for drainage catheter placement. The accordion catheter is a 6.5 French Teflon catheter with a sigmoid tip. With the use of monofilament, the sigmoid tip can be retracted into a "T" configuration to prevent dislodgment. The 22-gauge needle guide, preloaded with an accordion catheter, can be manipulated safely while the drainage target is located. Then the accordion catheter can be advanced into the target over the needle guide. The "accordion" is easily formed, even in small targets. Successful drainage was achieved in 127 of 131 drainage procedures in which this technique was used. Sepsis did not occur as a complication in any of these procedures.

The standard deflecting handle and deflecting wire have been modified to permit deflectors to be used as exchange wires. The spherical knobs are removed from the proximal end of the deflecting wire, and simple inserts are attached to the deflector handle. The handle can be used with deflector wires that have various length extensions (J or straight floppy tips) and with guidewires of variable stiffness.