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Multiple myeloma (MM) remains incurable despite the availability of novel agents. This multi-center retrospective cohort study used the Canadian Myeloma Research Group Database to describe real-world outcomes of patients withanti-CD38 monoclonal antibody (mAb) refractory MM subsequently treated with standard of care (SoC) regimens. Patients with triple class refractory (TCR) disease (refractory to a proteasome inhibitor, immunomodulatory drug, and anti-CD38 mAb) were examined as a distinct cohort. Overall, 663 patients had disease progression on anti-CD38 mAb therapy, 466 received further treatment (346 with SoC regimens were included, 120 with investigational agents on clinical trial and were excluded). The median age at initiation of subsequent SoC therapy of 67.9 (range 39.6–89.6) years with a median of 3 prior lines (range 1–9). The median PFS and OS from the start of subsequent therapy was 4.6 (95% CI 4.1–5.6) months and 13.3 (95% CI 10.6–16.6) months, respectively. The median PFS and OS of patients with TCR disease (n = 199) was 4.4 (95% CI 3.6–5.3) months and 10.5 (95% CI 8.5–13.8) months. Our results reinforce that real-world patients with relapsed MM, particularly those with TCR disease, have dismal outcomes. There remains an urgent unmet need for the development of and access to effective therapeutics for these patients. [ABSTRACT FROM AUTHOR]

Background: Cognitive impairment and sarcopenia have become important challenges for the growing aging population. Social support has been shown to protect against cognitive impairment, but its impact on sarcopenia remains unknown. The purpose of this study was to explore the correlation between social support, sarcopenia, and cognitive impairment in Chinese older adults. Method: A multi-stage whole group sampling method was used to conduct a cross-sectional survey of 720 community-dwelling older people in Shanghai. The definition of sarcopenia was in accordance with the criteria of the Asian Working Group for Sarcopenia (AWGS) 2019. Cognitive impairment was evaluated using a computerized neuropsychological assessment device that had been previously validated. Social support was assessed using the Social Support Rate Scale. Logistic regression analyses were conducted to explore the relationship between social support cognitive impairment and sarcopenia, fully adjusting for all potential confounding factors. Results: Our study found that 230 (31.94%) of the participants had cognitive impairment and 97 (13.47%) of the participants had sarcopenia. The mean social support score was 35.10 ± 7.54. Besides, the results showed that cognitive impairment was associated with sarcopenia (OR:1.650, 95% CI: 1.048, 2.596, P=0.030) after adjusting for confounding factors. Older adults with high level social support had the lowest risk of cognitive impairment (OR: 0.297, 95% CI: 0.115, 0.680, P=0.021) and sarcopenia (OR: 0.113, 95% CI: 0.031, 0.407, P=0.001), respectively. Conclusion: Our analysis revealed that high level social support was negatively associated with sarcopenia and cognitive impairment. These findings provide strong support for the health promotion effect of social networks against sarcopenia and cognitive impairment in Chinese community-dwelling older adults, with important implications for healthcare policy makers. [ABSTRACT FROM AUTHOR]

Summary: Follow-up raloxifene therapy after denosumab discontinuation resulted in a decrease in bone mass to the pre-denosumab levels and a rebound increase of bone turnover markers. The decrease in lumbar bone mineral density was particularly evident when the body mass index was low, there were previous vertebral fractures, or lumbar bone mineral density before denosumab administration was low. Introduction: Selective estrogen receptor modulators may be an alternative to bisphosphonates for treating rebound resorption after discontinuing denosumab. This study aimed to investigate the effects of follow-up raloxifene therapy after denosumab discontinuation in postmenopausal women. Methods: This retrospective observational study included 61 patients who received 12-month follow-up raloxifene therapy after denosumab discontinuation. The primary endpoint was the bone mineral density change. The secondary endpoints were the changes in bone turnover markers and the incidence of new vertebral fractures. Results: Raloxifene administration for 12 months after denosumab discontinuation resulted in a significantly lower bone mineral density at all sites compared to the level at 6 months after the last denosumab treatment (lumbar spine, − 5.48%; femoral neck, − 2.95%; total hip, − 3.52%; all, p < 0.001). The decrease in lumbar bone mineral density was particularly evident when the body mass index was low, there were previous vertebral fractures, or lumbar bone mineral density before denosumab administration was low. Marked increases in the bone turnover markers from baseline were noted after switching to raloxifene. However, no new vertebral fractures occurred during raloxifene treatment. Conclusions: Follow-up raloxifene therapy after denosumab discontinuation resulted in a decrease in bone mass to the pre-denosumab levels and a rebound increase of bone turnover markers. Therefore, raloxifene administered sequentially after denosumab discontinuation was not effective in preventing rebound phenomenon. [ABSTRACT FROM AUTHOR]

Summary: Population-based cohort study of 6,548,784 Korean subjects demonstrates that the risk of fracture was higher in patients with diabetes than in nondiabetic subjects. Furthermore, patients with type 1 diabetes were associated with a higher risk of fracture than patients with type 2 diabetes for all measurement sites. Introduction: Diabetes mellitus is associated with increased fracture risk. Although the pathophysiologic effect on bone metabolism differs according to the type of diabetes, a higher risk of fracture in patients with diabetes than in nondiabetic patients has been consistently demonstrated. Considering the ever-increasing number of patients with diabetes, we aimed to provide updated information on whether this phenomenon remains valid in real-world settings by using large-scale population datasets. Methods: We conducted a retrospective longitudinal study using data from the Korean National Health Insurance Service dataset of preventive health check-ups between January 2009 and December 2016. The hazard ratios were calculated for any fracture, vertebral fracture, and hip fracture and were analyzed according to the presence and type of diabetes. Among 10,585,818 subjects, 6,548,784 were eligible for the analysis (2418 patients with type 1 diabetes mellitus [T1DM] and 506,208 patients with type 2 diabetes mellitus [T2DM]). Results: The mean follow-up duration (in years) was 7.0 ± 1.3 for subjects without diabetes, 6.4 ± 2.0 for those with T1DM, and 6.7 ± 1.7 for T2DM. Patients with T1DM had a higher incidence rate for all types of fractures per 1000 person-years. The fully adjusted hazard ratios (HRs) for any fracture, vertebral fracture, and hip fracture were higher in T1DM than in T2DM (1.37 [95% confidence interval (CI): 1.23–1.52] for any fracture, 1.33 [95% CI: 1.09–1.63] for vertebral fracture, and 1.99 [95% CI: 1.56–2.53] for hip fracture). Conclusions: In this large-scale population analysis, diabetes was associated with a higher risk of all types of fractures. Patients with T1DM had a higher risk of fracture than those with T2DM for all measurement sites, and hip fractures had the highest risk. Therefore, fracture prevention training for patients with diabetes is advisable. [ABSTRACT FROM AUTHOR]

A neutral elastic inhomogeneity does not affect the existing stress field when inserted into an elastic body. It has been shown that no such inhomogeneity can exist under the classical assumption of a perfectly bonded interface between the inhomogeneity and the surrounding material. We show that by introducing a suitable temperature field inside the inhomogeneity it is indeed possible to achieve neutrality regardless of the perfect bonding assumption. Specifically, we show that a nonuniform internal temperature field can induce neutrality in an inhomogeneity in the form of an elastic ring with concentric internal and external boundaries of arbitrary shape. Noting that such a temperature field can be identified also in the case of an unpunched inhomogeneity when the inhomogeneity is line-shaped, we further prove that even a flake-shaped inhomogeneity can be made neutral if the thickness of the flake is much smaller than its length. In the case that the elastic body surrounding the unpunched inhomogeneity is subjected to remote hydrostatic loading, the temperature field within the inhomogeneity will remain uniform and independent of the shape of the inhomogeneity. In fact, in this case, the temperature field inside the inhomogeneity depends only on the elastic parameters of the composite and the direction of the remote loading and can be higher or lower than the operating temperature of the composite. [ABSTRACT FROM AUTHOR]

We consider the electric, thermal and elastic fields in an infinite conductor or semiconductor plate containing an arbitrarily shaped inhomogeneity. Complex variable and numerical methods are used to discuss effective conductivities and the effect of electric current on the thermal stress distribution. Our results show that the effective electric and thermal conductivities depend strongly on the shape and size of the inhomogeneity. In addition, the electric current generates considerable thermal stress in the vicinity of the inhomogeneity allowing for the possibility of enhancing or neutralizing any thermal stress induced by heat flux. Detailed analyses indicate that the remote electric current suppresses the maximum normal stress while either suppressing or enhancing the maximum shear and hoop stresses around an arbitrarily shaped inhomogeneity depending on the material parameters and shape of the inhomogeneity. Our findings also allow us to conclude that the electric current suppresses maximum normal and shear stresses on the interface in the case of a triangular inhomogeneity, which, of course, dramatically reduces the threat of interface debonding which is known to be one of the main causes of failure in composites. This research provides a theoretical basis for the prediction of the effective performance as well as for the control of thermal stress in composites. [ABSTRACT FROM AUTHOR]

Background and objectives: Stem cell factor (SCF), the ligand of the c-kit receptor, actively participates in the organ reconstruction and fibrosis associated with various diseases, including kidney disease. However, it remains unclear whether SCF plays a role in kidney aging. Design, setting, participants, and measurements: In the present study, we measured the serum SCF level, estimated glomerular filtration rate (eGFR), and other biological parameters in a Chinese Han group of 892 subjects, and explored the relationship between SCF level and renal function during aging; we sought to define novel biomarkers of kidney aging. Results: Multiple linear regression was used to select potential indicators of decline in renal function. Only age, SCF level, and 25% maximum expiratory flow (25% MEF) were significant predictors after redundancy analysis (|r| > 0.70 and P < 0.05). Multiple linear regression showed that the relationship among eGFR, SCF level, and age could be described as follows: eGFR = 154.486 - (0.846 × age) - (0.011 × SCF level). Conclusions: We found no between-gender difference in the effect of SCF on kidney aging. In conclusion, the SCF level is an ideal biomarker of renal aging and may help to predict changes in eGFR during aging. [ABSTRACT FROM AUTHOR]

This study was conducted to determine the emission characteristics of volatile organic compounds associated with coating methods including brush, roll, and spray. A concrete waterborne paint, three concrete oil-borne paints, and four wood oil-borne paints were selected in this work. It was observed that the emission of volatile organic compounds from paints was affected by the coating methods. The emission time of volatile organic compounds from a spray painting process was faster than that of brush and roll painting. In contrast, the emission characteristics of volatile organic compounds from coating materials applied by brush and roller was statistically similar. The α-dicarbonyl formation potential in the indoor air according to the reaction of volatile organic compounds and OH radical was also estimated. It was observed that the concentration of alpha-dicarbonyl might reach 2.2 μg/m3 (product A2, spray method). Spray method might help to control volatile organic compounds and the formation of α-dicarbonyl from coating process in the indoor environment more effectively than other methods because the accumulative emission of volatile organic compounds during spray coating process could be removed easily. [ABSTRACT FROM AUTHOR]

Summary: Analyses using the largest Korean cohort of adrenal incidentaloma (AI) revealed that subtle cortisol excess in premenopausal women and reduced dehydroepiandrosterone-sulfate (DHEA-S) in postmenopausal women and men are associated with bone mineral density (BMD) reduction in Asian patients with subclinical hypercortisolism (SH). Introduction: Few studies evaluated bone metabolism in Asians with SH. We investigated associations of cortisol and DHEA-S, an adrenal androgen, with BMD in Asians with AI, with or without SH. Methods: We used cross-sectional data of a prospective multicenter study from Korea. We measured BMD, bone turnover markers, cortisol levels after 1-mg dexamethasone suppression test (1-mg DST), DHEA-S, and baseline cortisol to DHEA-S ratio (cort/DHEA-S) in 109 AI patients with SH (18 premenopausal, 38 postmenopausal women, and 53 men) and 686 with non-functional AI (NFAI; 59 premenopausal, 199 postmenopausal women, and 428 men). Results: Pre- and postmenopausal women, but not men, with SH had lower BMDs at lumbar spine (LS) than those with NFAI (P = 0.008~0.016). Premenopausal women with SH also had lower BMDs at the hip than those with NFAI (P = 0.009~0.012). After adjusting for confounders, cortisol levels after 1-mg DST demonstrated inverse associations with BMDs at all skeletal sites only in premenopausal women (β = − 0.042~− 0.033, P = 0.019~0.040). DHEA-S had positive associations with LS BMD in postmenopausal women (β = 0.096, P = 0.001) and men (β = 0.029, P = 0.038). The cort/DHEA-S had inverse associations with LS BMD in postmenopausal women (β = − 0.081, P = 0.004) and men (β = − 0.029, P = 0.011). These inverse associations of cort/DHEA-S remained significant after adjusting for cortisol levels after 1-mg DST (β = − 0.079~− 0.026, P = 0.006~0.029). In postmenopausal women, the odds ratios of lower BMD by DHEA-S and cort/DHEA-S was 0.26 (95% CI, 0.08–0.82) and 3.40 (95% CI, 1.12–10.33), respectively. Conclusion: Subtle cortisol excess in premenopausal women and reduced DHEA-S in postmenopausal women and men may contribute to BMD reduction in Asians with SH. [ABSTRACT FROM AUTHOR]

This study was carried out to evaluate the effect of deformation twinning in Ti-15Mo alloys. The material was rolled to reduce the thickness by 88% and recrystallized at 900°C for 10 min. To observe deformation twinning, electron backscattering diffraction was applied, and the grain boundary characteristic distributions were analyzed. Application of rolling and recrystallization promoted development of texture with a {111}//ND component, which was a result of the lower phase stability. In particular, material subjected to tensile strain showed dense deformation twins with a component of {332} <113> that promoted the strength, r, and n values without a significant decrease in elongation. These phenomena are attributed to the enhanced strain-hardening exponent due to deformation twinning. [ABSTRACT FROM AUTHOR]

This study was carried out to evaluate the effect of grain misorientation angle distribution on the deformation behavior and twinning of Ti-15Mo alloy. Cold rolling exhibited a significant texture with grains oriented along the {111}//normal direction, which correlate with a higher fraction of low-angle boundaries. This material showed a lower yield strength and higher elongation than those of the hot rolled material. The twinning propagation mainly occurred between neighboring grains with a low-angle relation. Consequently, the texture development was correlated with low-angle boundaries and affected by the increase in the twinning density, which increased the strain hardening rate. [ABSTRACT FROM AUTHOR]

In this work, the microstructure and mechanical properties of rapidly solidified Ti50−x/2Ni50−x/2Hfx (x = 0, 2, 4, 6, 8, 10, and 12 at.%) and Ti50−y/2Ni50−y/2Siy (y = 1, 2, 3, 5, 7, and 10 at.%) shape memory alloys (SMAs) were investigated. The sequence of the phase formation and transformations in dependence on the chemical composition is established. Rapidly solidified Ti-Ni-Hf or Ti-Ni-Si SMAs are found to show relatively high yield strength and large ductility for specific Hf or Si concentrations, which is due to the gradual disappearance of the phase transformation from austenite to twinned martensite and the predominance of the phase transformation from twinned martensite to detwinned martensite during deformation as well as to the refinement of dendrites and the precipitation of brittle intermetallic compounds. [ABSTRACT FROM AUTHOR]

Objectives: We aimed to evaluate the relationship between baseline renal function and changes in telomere length in Han Chinese.Methods: The telomere restriction fragment (TRF) length of leukocytes in the peripheral blood was measured in healthy volunteers recruited in 2014. The estimated glomerular filtration rate (eGFR) was calculated based on serum creatinine (Scr) and serum cystatin C (CysC)-eGFRcys and eGFRScr-cys through the Cockcroft-Gault formula (eGFRC-G) or the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI / eGFRCKD-EPI) equation. The correlation between telomere length changes over time and renal function was analyzed.Results: Leukocyte TRF lengths were negatively correlated to age (r = -0.393, p < 0.001) and serum CysC (r = -0.180, p < 0.01), while positively associated with eGFRCKD-EPI, eGFRC-G, eGFRcys, and eGFRScr-cys (r = 0.182, 0.122, 0.290, and 0.254 respectively, p < 0.01). The 3-year change of telomere length was 46 bp/years. When adjusted for age, the associations between telomere length changes and baseline, subsequent TRF lengths, and serum CysC were no longer present. No association was observed between TRF length changes and renal function.Conclusion: The rate of telomere length changes was affected by age and baseline telomere length. The telomere length changes might be important markers for aging. [ABSTRACT FROM AUTHOR]

The influence of phosphorus on κ-carbide precipitation and alloy partitioning in an austenitic Fe-30Mn-9Al-1Si-0.9C-0.5Mo cast steel was studied utilizing a combination of transmission electron microscopy, 3D atom probe tomography, X-ray diffraction, and first-principles atomistic modeling. Increasing the amount of phosphorus from 0.006 to 0.043 wt pct P increased the kinetics of the initial ordering reaction. Specimens from the high-phosphorus steel showed some degree of short-range ordering of Fe-Al-C that took place during the quench. It was shown that phosphorus increases both the size and volume fraction of κ-carbide during aging. However, the distribution of phosphorus appears to be homogeneous, and thus long-range diffusion of phosphorus was not responsible for the observed increase in hardening. It is shown that phosphorus encourages the initial short-range ordering into the E2 structure of κ-carbide and also accelerates spinodal decomposition associated with carbon and aluminum diffusions. [ABSTRACT FROM AUTHOR]

Methicillin-resistant Staphylococcus aureus bacteremia (MRSAB) often persists despite appropriate antibiotic therapy. It is unclear what microbiological factors contribute to poor clinical outcomes in persistent MRSAB (pMRSAB). We aimed to identify clinical and microbiological risk factors for in-hospital mortality in pMRSAB. We analysed MRSAB cases prospectively collected between 2009 and 2016 at 11 hospitals in Korea, defining cases of pMRSAB as MRSAB lasting ≥5 days despite administration of effective antibiotics. The first blood isolates from the pMRSAB cases were tested for staphylococcal cassette chromosome mec type, staphylococcal protein A type, accessary gene regulator ( agr) type, genes for Panton-Valentine leukocidin and phenol-soluble modulin- mec, vancomycin minimum inhibitory concentration, vancomycin heteroresistance, and agr functionality. We also collected clinical information for each case. Of 960 MRSAB cases, 152 pMRSAB were finally eligible. Univariable analysis revealed that in-hospital mortality was significantly associated with Charlson's comorbidity-weighted index (CCWI) score, Pitt bacteremia score, sequential organ failure assessment score, presentation with septic shock, pneumonia, agr dysfunction, and vancomycin heteroresistance. Bone and joint infections were negatively associated with in-hospital mortality. Multivariable analysis revealed the following independent risk factors for in-hospital mortality: CCWI score [adjusted odds ratio (aOR), per one point, 1.25; 95% confidence interval (CI), 1.08-1.44; P = 0.003), Pitt bacteremia score (aOR, per one point, 1.33; 95% CI, 1.09-1.62; P = 0.005), non-eradicated foci of infection (aOR, 3.12; 95% CI, 1.18-8.27; P = 0.022), and agr dysfunction (aOR, 2.48; 95% CI, 1.12-5.47; P = 0.025). agr dysfunction is an independent risk factor for in-hospital mortality in pMRSAB. [ABSTRACT FROM AUTHOR]

This study was conducted to evaluate the effect of the grain size and orientation on the formation of deformation twins in Ti-15Mo alloy. For this material, cold rolling was carried out to achieve a 90% thickness reduction on the samples. In order to recrystallize the severely deformed alloy and to obtain two types of grain sizes, the alloys were then annealed at 900 °C for 1 and 30 min, respectively. After this work, electron backscattered diffraction was introduced to analyze grain boundary character distributions. As a result, the coarsened grains (average size ~154 μm) formed denser deformation twins relative to that of the finer grains (average size ~25 μm), which was attributed to the grain boundary constraint and orientation. These effects led to an enhancement of the strain-hardening constant of the alloy, which in turn resulted in a notable increase in the elongation without any significant decrease in the tensile strength. In this study, we systematically discussed the formation of twins in terms of grain size and Schmid factor. [ABSTRACT FROM AUTHOR]

Purpose: Injection of adipose tissue-derived stem cells (ASCs) is a novel method for the treatment of complex perianal fistulas. We aimed to evaluate the safety and efficacy of ASCs in the treatment of complex anal fistulas not associated with Crohn's disease. Methods: A phase II clinical trial was performed comparing two different doses of ASCs (group 1: 1 × 10 cells/mL and group 2: 2 × 10 cells/mL). Eligible patients were administered an amount of ASCs proportional to the length of the fistula by injection into the submucosal layer surrounding the internal opening and inside of the fistula tract. ASCs at twice the initial concentration were administered if complete closure was not achieved within 8 weeks. The efficacy endpoint was the complete closure of fistulas 8 weeks after injection. Patients demonstrating complete closure at week 8 were subjected to follow-up for 6 months. Results: Fifteen patients were injected with ASCs; thirteen completed the study. Complete closure was observed in 69.2% (9/13) of patients at 8 weeks. Three of five patients in group 1, and six of eight in group 2 displayed complete closure; no significant differences were observed between the groups. Six of nine patients who showed complete closure participated in additional follow-up; five (83.3%) showed persistent response at 6 months. No grade 3 or 4 adverse events (AEs) were observed; observed AEs were not related to ASC treatment. Conclusion: ASCs might be a good option for the treatment of complex perianal fistulas are not healed by conventional operative procedures. [ABSTRACT FROM AUTHOR]

Cefazolin treatment failure has been observed in high-inoculum infections caused by methicillin-susceptible Staphylococcus aureus (MSSA) with a cefazolin inoculum effect (CIE). However, data on the characteristics and risk factors for the acquisition of CIE-positive MSSA infection are scarce. CIE positivity was measured as an MIC ≥ 16 μg/ml with a high inoculum (∼5 × 10 CFU/ml). The blaZ gene type was assessed through sequence analysis. The clinical characteristics and risk factors for the acquisition of CIE-positive MSSA infection were assessed. The association between the antimicrobial susceptibility profile and CIE positivity was evaluated. A total of 303 MSSA bacteraemia cases and their corresponding isolates were collected from ten hospitals: 61 (20.1 %) isolates showed a positive CIE; 254 (83.8 %) were positive for the blaZ gene. No significant association was found between CIE positivity and the site of infection. Metastatic cancer (aOR 2.86, 95 % CI, 1.10-7.48) and recent (≤1 month) close contact with a chronically ill patient (aOR 4.69, 95 % CI, 1.76-12.50) were identified as significant risk factors for CIE-positive MSSA infection through multivariate analyses. Resistances to clindamycin (OR 3.55, 95 % CI, 1.62-7.80) and erythromycin (OR 5.00, 95 % CI, 2.50-9.99) were associated with CIE positivity, presenting high specificity (92.9 %) and a negative predictive value (82.3 %). CIE-positive MSSA constituted approximately one-fifth of MSSA bacteraemia cases. Although CIE positivity was not clinically discernible, CIE positivity was associated with clindamycin or erythromycin susceptibility. Therefore, our findings suggest that cefazolin can be used in the treatment of high-inoculum MSSA infection if the isolates are susceptible to clindamycin or erythromycin. [ABSTRACT FROM AUTHOR]

This paper demonstrates the ability to determine the individual full-field components of stress, strain and displacement in finite asymmetrical engineering structures from recorded values of a single displacement component while not necessitating differentiation of the measured displacement data; a process which can be ill-conditioned and adversely influenced by data noise and quality. While the present approach of processing recorded displacements with a stress function is not new, previous cases have been restricted to symmetrical scenarios. Full-field displacements are measured here using the digital image correlation (DIC) method. As well as satisfying load equilibrium, the experimental results agree with those predicted using the finite element method (FEM). [ABSTRACT FROM AUTHOR]

Blast waves generated from the muzzles of various weapons might have significant effects on the human body, and these effects are recognized as being more severe when weapons are fired indoors. The risk can be assessed by various criteria, such as waveform, exposed energy, and model-based types. This study introduces a prediction model of blast wave propagation for estimating waveform parameters related to damage risk assessment. To simulate indoor multiple reflections in a simple way, the model is based on the alternative image theory and discrete wavefront method. The alternative theory is a kind of modified image theory, but it uses the image space concept from a receiver's perspective, so that it shows improved efficiency for indoor problems. Further, the discrete wavefront method interprets wave propagation as the forward movement of a finite number of wavefronts. Even though the predicted results show slight differences from the measured data, the locations of significant shock waves indicate a high degree of correlation between them. Since the disagreement results not from the proposed techniques but from the assumptions used, it is concluded that the model is appropriate for analysis of blast wave propagation in interior spaces. [ABSTRACT FROM AUTHOR]

In the present work, in order to investigate the grain refinement mechanism of AM containing Sn alloys, the as-cast AM60, AM90 alloys, and the alloys with addition of 1 wt.% Sn were fabricated by traditional casting, respectively. During the solidification of AM + Sn alloys, the morphology of divorced eutectic MgAl was refined by MgSn intermetallic that served as the heterogeneous nucleation cores. The modified MgAl effectively restricted the grain growth and resulted in a grain refinement. As a result, the yield strength of as-cast AM alloys was significantly enhanced by addition of Sn, while the ductility also improved. Moreover, the edge-to-edge model was employed to predict the orientation relationship between MgAl and MgSn. [ABSTRACT FROM AUTHOR]

Background/objectives:Previous studies have indicated that higher levels of food consumption are associated with fatty liver disease (FLD), but few studies have investigated the relationship between this disease and different dietary patterns. The aim of this cross-sectional study was to examine the association between dietary patterns and FLD in adults.Subjects/methods:Dietary intakes of participants in the Tianjin were assessed via questionnaire. Factor analysis was used to identify dietary patterns, and FLD was defined as having a FLD diagnosis using liver ultrasonography. Relationships between dietary patterns and FLD were assessed using multiple logistic regression analysis.Results:Female participants in the highest quartile of high-carbohydrate/sweet pattern scores had a 2.19-fold greater risk (95% confidence interval (CI), 1.40-3.46) of developing non-alcoholic FLD (NAFLD) than those in the lowest quartile after adjusting for confounding factors. No significant differences were found between any dietary pattern and NAFLD in males. In males, a significantly increasing trend of alcoholic FLD (AFLD) prevalence was associated with increasing high-protein/cholesterol pattern scores (P for trend=0.03; odds ratio (OR), 2.08; 95% CI, 1.15-3.81) while an increased high-carbohydrate/sweet pattern score appeared protective against AFLD (P for trend=0.02; OR, 0.55; 95% CI, 0.29-1.00).Conclusions:Our study demonstrates that high-protein/cholesterol pattern scores are associated with higher prevalence of AFLD in males. We also show high-carbohydrate/sweet pattern scores are associated with higher prevalence of NAFLD in females; but, interestingly, this pattern shows a favorable effect on AFLD in males. [ABSTRACT FROM AUTHOR]

A cellular automaton (CA) model coupled with Svoboda's analytic solution of diffusional phase transformation was established to simulate β-α transition in titanium alloy. A numeric definition of diffusion, mixed and interface mode transformation is put forward and simulated by the newly developed CA model. To the best of our knowledge, this is the first model that is capable of quantifying the effect of interface moving (interface mobility coefficient or transformation driving force factor) and solute diffusion process (diffusion coefficient) on phase transformation types. A critical interface mobility coefficient exists for mixed mode transformation, below and above which interface mode and diffusion mode dominate, respectively. This indicated that, in isothermal diffusion/mixed/interface mode phase transformations, solute diffusion distance and solute concentration gradient are decreasing gradually with time. Furthermore, it was found during cooling transformation that diffusion mode transformation at high temperature shifts to interface mode at low temperature, where a high cooling rate corresponds to a high transition temperature. [ABSTRACT FROM AUTHOR]

Primary graft failure (pGF) is a frequent complication following cord blood transplantation (CBT). For those patients who will not experience autologous recovery, salvage transplantation should be performed as early as possible. However, standardized treatment protocols for pGF, such as the optimal stem cell source, preparative regimen and the ideal time for salvage transplantation, have yet to be determined. Therefore, we analyzed 17 hematologic malignancy patients who received unmanipulated haploidentical peripheral blood (PB) and BM transplantation with reduced-intensity conditioning (RIC) as a salvage therapy for pGF after CBT. The median interval between the two transplantations was 38 days. The RIC regimen for salvage transplantation consisted of fludarabine, antithymocyte globulin, CY and low-dose TBI. The neutrophil and plt engraftments were achieved in 14 (82.4%) and 13 (76.4%) patients, respectively. The cumulative incidences of grades II-IV and grades III-IV aGVHD were 35.3% and 17.6%, respectively. The cumulative incidence of chronic GVHD was 29.4%. After a median follow-up of 43 months, 10 of 17 patients remained alive in CR. The cumulative incidence of TRM at 180 days was 29.4%. The probability of 3-year OS and leukemia-free survival was 57.5%. Our results show that unmanipulated haploidentical PB and BM transplantation under a RIC regimen is an effective treatment for pGF after CBT. [ABSTRACT FROM AUTHOR]

Plasmonic materials (PMs), featuring large static or dynamic tunability, have significant impact on the optical properties due to their potential for applications in transformation optics, telecommunications, energy, and biomedical areas. Among PMs, the carrier concentration and mobility are two tunable parameters, which control the plasma frequency of a metal. Here, we report on large static and dynamic tunability in wavelengths up to 640 nm in Al-doped ZnO based transparent conducting degenerate semiconductors by controlling both thickness and applied voltages. This extreme tunability is ascribed to an increase in carrier concentration with increasing thickness as well as voltage-induced thermal effects that eventually diminish the carrier concentration and mobility due to complex chemical transformations in the multilayer growth process. These observations could pave the way for optical manipulation of this class of materials for potential transformative applications. [ABSTRACT FROM AUTHOR]

Because of the brittle martensite crystalline structure, nanostructured bainitic steel is very difficult to be welded and easily form cracks in the welded joint, which limits the scope of their application. Regeneration treatment can lead to nanostructured bainite formation in the welded joints, preventing further degradation of the welded joint. Detailed changes of microstructures and mechanical properties of the weld are characterized here. Coarse inter-dendrite structures appear in the weld due to welding segregation, and are confirmed to be retained austenite by TEM. Moreover, an extraordinary combination of strength and ductility of the weld is achieved. The ultimate tensile strengths are 1913MPa and 2115MPa when regeneration temperatures are 250 °C and 230 °C. The corresponding elongations are 5.14% and 2.3%. In addition, the tension fracture behaviour and crack propagation mode of the weld are investigated. [ABSTRACT FROM AUTHOR]

This study included data from 185 consecutively treated patients, 16 years of age or older, who underwent myeloablative transplantation using unrelated umbilical cord blood (UCB) (UCB transplantation (UCBT), n=70) or HLA-identical sibling donor peripheral blood stem cells alone or combined with bone marrow (BMT/PBSCT, n=115) from October 2001 to December 2012. All patients received myeloablative regimens, cyclosporin A plus mycophenolate mofetil as prophylaxis for GVHD, and similar supportive care. Although hematopoietic recovery was significantly delayed after UCBT, the rate of neutrophil engraftment was comparable. The median follow-up was 53 months (range, 15-136 months) for BMT/peripheral blood SCT (PBSCT) recipients and 35 months (range, 10-123 months) for UCBT recipients. There were no significant differences in the cumulative incidence of grades III to IV acute GVHD, relapse rate, or 3-year probabilities of disease-free survival between patients receiving UCBT and those receiving BMT/PBSCT. However, the cumulative incidence of chronic and extensive chronic GVHD was lower in UCBT recipients. The rates of long-term survivors returning to school or work and off immunosuppressive therapy were significantly higher after UCBT, which indicated that long-term survivors who underwent UCBT had a higher quality of life. [ABSTRACT FROM AUTHOR]

Wetlands in the Lower Reaches of Songhua River (LRSR), Northeast China, are rich in biodiversity and natural resources, which provide crucial staging and wintering habitats for various endangered species. However, in the past five decades, the size of this wetland area has decreased, and its quality has deteriorated because of increased natural and human activities. Wetland restoration is critical to improve these conditions. In this study, hydrological regulation and habitat suitability, the most important wetland functions, were selected and analyzed to identify suitable wetland restoration sites. By using these two function layers, together with the geographic information system (GIS) spatial analysis function and remote sensing (RS) image data, we identified and prioritized suitable sites for wetland restoration in the LRSR. Areas with high hydrological regulation and good or fair waterbirds' habitat suitability can support wetland restoration. The potential sites were prioritized in terms of patch size and proximity to natural wetlands and water bodies. Finally, we obtained two priority classes (high and low) of wetland restoration in a spatial scale. The results from this study showed that the areas with high and low priority classes for wetland restoration are 82,628 and 247,039 ha, respectively, which account for 1.23% and 3.67% of the total study area. The high-priority class areas would be used for the wetland restoration. [ABSTRACT FROM AUTHOR]

The opioid system is implicated in the hedonic and motivational processing of food, and in binge eating, a behaviour strongly linked to obesity. The aim of this study was to evaluate the effects of 4 weeks of treatment with the mu-opioid receptor antagonist GSK1521498 on eating behaviour in binge-eating obese subjects. Adults with body mass index 30 kg m−2 and binge eating scale scores 19 received 1-week single-blind placebo run-in, and were then randomized to 28 days with either 2 mg day−1 GSK1521498, 5 mg day−1 GSK1521498 or placebo (N=21 per arm) in a double-blind parallel group design. The outcome measures were body weight, fat mass, hedonic and consummatory eating behaviour during inpatient food challenges, safety and pharmacokinetics. The primary analysis was the comparison of change scores in the higher-dose treatment group versus placebo using analysis of covariance at each relevant time point. GSK1521498 (2 mg and 5 mg) was not different from placebo in its effects on weight, fat mass and binge eating scores. However, compared with placebo, GSK1521498 5 mg day−1 caused a significant reduction in hedonic responses to sweetened dairy products and reduced calorific intake, particularly of high-fat foods during ad libitum buffet meals, with some of these effects correlating with systemic exposure of GSK1521498. There were no significant effects of GSK1521498 2 mg day−1 on eating behaviour, indicating dose dependency of pharmacodynamics. GSK1521498 was generally well tolerated and no previously unidentified safety signals were detected. The potential for these findings to translate into clinically significant effects in the context of binge eating and weight regain prevention requires further investigation. [ABSTRACT FROM AUTHOR]

Several cytogenetic abnormalities are associated with poor outcomes in multiple myeloma (MM). We prospectively analyzed the impact of cytogenetic abnormalities on outcomes during the phase 2 PX-171-003-A1 study of single-agent carfilzomib for relapsed and refractory MM. In the response-evaluable population (257/266), fluorescence in situ hybridization (FISH)/conventional cytogenetic profiles were available for 229 patients; 62 (27.1%) had high-risk cytogenetics-del 17p13, t(4;14) or t(14;16) by interphase FISH or deletion 13 or hypodiploidy by metaphase cytogenetics-and 167 (72.9%) had standard-risk profiles. Generally, baseline characteristics were similar between the subgroups, but International Staging System stage III disease was more common in high- vs standard-risk patients (41.9% vs 27.5%) as was Eastern Cooperative Oncology Group performance status 1/2 (85.5% vs 68.3%). Overall response was comparable between the subgroups (25.8% vs 24.6%, respectively; P=0.85), while time-to-event end points showed a trend of shorter duration in high-risk patients, including median duration of response (5.6 months (95% confidence interval (CI) 3.7-7.8) vs 8.3 months (95% CI 5.6-12.3)) and overall survival (9.3 (95% CI 6.5-13.0) vs 19.0 months (95% CI 15.4-NE); P=0.0003). Taken together, these findings demonstrate that single-agent carfilzomib is efficacious and has the potential to at least partially overcome the impact of high-risk cytogenetics in heavily pre-treated patients with MM. [ABSTRACT FROM AUTHOR]

The precipitates, magnetism, and corrosion resistance of FeSiB glassy samples fabricated in vacuum and air atmospheres (labeled as VAC and AIR samples, respectively) were studied. The findings show that the fraction of the amorphous phase in VAC samples is lower than that in the AIR counterparts. The Fe phase in VAC samples grows preferentially along the 〈200〉 orientation. The distribution of magnetization M of VAC samples oriented parallel and orthogonal to the field ( H and H) at H = 4000 Oe is more scattered than AIR samples. The corrosion resistance of VAC samples is lower than AIR counterparts, which can be attributed to the minor alloying effect of oxygen and the passive effect of silicon atoms supplied from the amorphous phase. [ABSTRACT FROM AUTHOR]

The effect of pre-existing shear bands induced by cold-rolling on the crystallization behavior was investigated in the Cu46Zr46Al8 bulk metallic glass. It was found that with increasing degree of pre-deformation, more shear bands are created resulting in the decrease of the crystallization activation energy for the alloy. Our experimental results demonstrate that pre-existing shear bands can promote the nucleation of crystals, which is discussed in terms of nucleation thermodynamics and kinetics aspects. [ABSTRACT FROM AUTHOR]

In this work, the fission gas distribution of an irradiated oxide fuel was investigated by measuring the fission gas release (FGR) and retained gas from and in an oxide fuel along the axial height of the fuel rod. In addition to the fission gas measurements, other destructive and non-destructive post irradiation examination tests such as gamma scanning, eddy current testing, density and oxide layer thickness measurements, and ceramography/metallography were conducted to review their impact on the FGR and gas retention. A lead rod was extracted from a lead test assembly, which was irradiated to 56.9 GWd/tU during three irradiation cycles for a total exposure of 1,406 effective full power days. Considering the water-side oxide layer thickness and local burnup of the fuel rod, the rod was sectioned into four positions along the axial height and four samples were prepared from these positions. A sample fragment of around 0.1-0.2 g was individually melted to measure its retained krypton and xenon concentration. According to the measurement results, the retained krypton and xenon concentration ranges were 0.114-0.139 cc/gU and 1.073-1.338 cc/gU, respectively, and their retention percentage after normalization of the sample local burnup showed a decreasing trend as the axial height of the fuel rod raised. The water-side oxide layer thickness scope of the tested fuels measured by an observation of the optical microscope images was 13-42 μm, and the thickness was increased along the axial height of the rod. The amount of released krypton and xenon into the rod-free volume was measured as 5.7 and 54.6 cc, respectively, by a rod puncturing/collection procedure, which corresponds to a 1.94 % fractional fission gas release referring to fission gas generation by a code calculation. [ABSTRACT FROM AUTHOR]

Estrogen receptor α (ERα) has critical roles in the development and progression of breast cancer, and the coiled-coil co-activator (CoCoA) is an important ERα co-activator for estrogen-induced gene expression. The small ubiquitin-like modifier (SUMO) pathway is hyperactivated in breast cancer, but the mechanism by which SUMOylation regulates ERα-mediated transcription remains poorly understood. Here, we identified ZFP282 as a CoCoA-binding protein. ZFP282 associates directly with ERα and cooperates synergistically with CoCoA to enhance ERα function. ZFP282 is required for estrogen-induced expression of ERα target genes and estrogen-dependent breast cancer cell growth and tumorigenesis. In addition, we found that ZFP282 is SUMOylated and that SUMOylation positively regulates the co-activator activity of ZFP282 by increasing its binding affinity to ERα and CoCoA, and consequently increasing recruitment of ZFP282-CoCoA complex to the promoter of ERα target genes. These findings reveal essential roles for ZFP282 and its SUMOylation in estrogen signaling and breast tumorigenesis. [ABSTRACT FROM AUTHOR]

Aims/hypothesis: Fractalkine (FKN) is a unique chemokine that works as a chemoattractant and an adhesion molecule. Previous studies have demonstrated that FKN plays a role in ischaemic and protein-overload renal injury via its cognate receptor chemokine (C-X3-C motif) receptor 1 (CX3CR1). However, involvement of the FKN/CX3CR1 system in diabetic nephropathy remains unclear. We examined the role of FKN/CX3CR1 in diabetic mice and mouse mesangial cells (MMCs). Methods: Streptozotocin (50 mg kg day) was intraperitoneally administered for 5 days to male Cx3cr1-knockout (KO) mice and wild-type (WT) mice. MMCs transfected with Fkn (also known as Cx3cl1) or Cx3cr1 siRNA, respectively, were used to elucidate the role of FKN/CX3CR1 in extracellular matrix (ECM) synthesis. Results: At 12 weeks, diabetic Cx3cr1 KO mice showed no significant changes in plasma glucose, but markers of renal inflammation, fibrosis and ECM, such as the fractional mesangial area, fibronectin and collagen, were significantly lower in diabetic Cx3cr1 KO mice compared with diabetic WT mice. High glucose, oleic acid and TGF-β1 stimulated FKN and CX3CR1 expression, together with the expression of ECM proteins in MMCs, but the effects were significantly attenuated by Fkn or Cx3cr1 siRNA. More importantly, FKN itself increased mesangial ECM through CX3CR1 and subsequent activation of reactive oxygen species and mitogen-activated protein kinases. A neutralising TGF-β antibody inhibited FKN/CX3CR1 in MMCs treated with diabetic stimuli and decreased FKN-induced ECM accumulation. Conclusions/interpretation: These results demonstrate that FKN/CX3CR1 may play an important role in diabetic renal injury through upregulation of ECM synthesis and could therefore be a therapeutic target for preventing diabetic nephropathy. [ABSTRACT FROM AUTHOR]

MnO-modified Ba(TiZr)O ceramics have been prepared by the conventional solid-state reaction technique at different sintering temperatures. Room-temperature piezoelectric properties, thermal stability, and crystalline structures were investigated. It was found that both the MnO additive and sintering temperature significantly influence the piezoelectric properties of the MnO-modified Ba(TiZr)O ceramics. The sample sintered at 1400°C exhibited the best room-temperature piezoelectric properties of Q = 1907, d = 205 pC/N, and k = 40.5% with tan δ = 0.46%, and its k remains larger than 35% in the broad temperature range from −38°C to 65°C. The results indicate that MnO-modified Ba(TiZr)O ceramics are promising lead-free materials for frequency device and power device applications. [ABSTRACT FROM AUTHOR]

This study was conducted to investigate the microstructure and mechanical properties of friction stir lap joints. Monel 400 and Inconel 600 were selected as the experimental materials, and friction stir welding was carried out at a tool rotation speed of 200 rpm and welding speed of 100 mm/min. The application of friction stir welding to Monel 400 effectively reduced the grain size in the stir zone; the average grain size of Monel 400 was reduced from 11.9 μm in the base material to 4.2 μm in the stir zone, which resulted in an improvement in the mechanical properties of the stir zone. The joint interface between Monel 400 and Inconel 600 showed a relatively sound weld without grooves or cracks, and only a small amount of voids with a size of 0.5 μm; however, no intermetallic compounds were observed in the lap jointed interface. Moreover, the hook on the advancing side of Monel 400 was formed from Inconel 600, which contributed to maintenance of the tensile strength. The evolution of microstructures and mechanical properties of friction stir lap jointed Monel 400 and Inconel 600 are also discussed herein. [ABSTRACT FROM AUTHOR]

Human adipose-derived adult stem cells (hADSCs) can express human telomerase reverse transcriptase phenotypes under an appropriate culture condition. Because adipose tissue is abundant and easily accessible, hADSCs offer a promising source of stem cells for tissue engineering application and other cell-based therapies. However, the shortage of cells number and the difficulty to proliferate, known as the 'Hayflick limit' in vitro, limit their further clinical application. Here, hADSCs were transfected with human telomerase reverse transcriptase (hTERT) gene by the lentiviral vector to prolong the lifespan of stem cells and even immortalize them. Following to this, the cellular properties and functionalities of the transfected cell lines were assayed. The results demonstrated that hADSCs had been successfully transfected with hTERT gene (hTERT-ADSCs). Then, hTERT-ADSCs were initially selected by G418 and subsequently expanded over 20 passages in vitro. Moreover, the qualitative and quantitative differentiation criteria for 20 passages of hTERT-ADSCs also demonstrated that hTERT-ADSCs could differentiate into osteogenesis, chondrogenesis, and adipogenesis phenotypes in lineage-specific differentiation media. These findings confirmed that this transfection could prolong the lifespan of hADSCs. [ABSTRACT FROM AUTHOR]

This study presents a rapid and quantitative sequential radiochemical separation method for Pu, U, Am and Sr isotopes in environmental samples with extraction chromatographic resins. After radionuclides were leached from the samples with 6 M HNO, Pu and U isotopes were adsorbed onto the UTEVA column and Am isotopes were adsorbed onto the TRU column connected with the UTEVA column. Also, Sr was adsorbed onto the Sr column connected with the TRU column. Pu and U isotopes were purified from other nuclides through the UTEVA column. In addition, Am isotopes were separated from other nuclides with the TRU column. Finally, Sr was purified with the Sr resin. After α source preparation for the purified Pu, U and Am isotopes with micro-coprecipitation method, Pu, U and Am isotopes were measured using alpha spectrometry. On the other hand, Sr was measured using a low level liquid scintillation counter. The radiochemical procedure for Pu, U, Am and Sr nuclides investigated in this study has been applied to environmental samples after validating the simulated samples. [ABSTRACT FROM AUTHOR]

This study proposes an aerodynamically optimized outer shape of a sedan by using an Artificial Neural Network (ANN), which focused on modifying the rear body shapes of the sedan. To determine the optimization variables, the unsteady flow field around the sedan driving at very fast speeds was analyzed by CFD simulation, and fluctuations of the drag coefficient (C) and pressure around the car were calculated. After consideration of the baseline result of CFD, 6 local parts from the end of the sedan were chosen as the design variables for optimization. Moreover, an ANN approximation model was established with 64 experimental points generated by the D-optimal methodology. As a result, an aerodynamically optimized shape for the rear end of the sedan in which the aerodynamic performance is improved by about 5.64% when compared to the baseline vehicle is proposed. Finally, it is expected that within the accepted range of shape modifications for a rear body, the aerodynamic performance of a sedan can be enhanced so that the fuel efficiency of the sedan can be improved. The YF SONATA, a sedan manufactured by Hyundai Motors Corporate, played a major role in this research as the baseline vehicle. [ABSTRACT FROM AUTHOR]

Elevated plasma levels of lipoprotein-associated phospholipase A2 (Lp-PLA2) activity have been shown to be associated with increased risk of coronary heart disease and an inhibitor of this enzyme is under development for the treatment of that condition. A Val279Phe null allele in this gene, that may influence patient eligibility for treatment, is relatively common in East Asians but has not been observed in Europeans. We investigated the existence and functional effects of low frequency alleles in a Western European population by re-sequencing the exons of PLA2G7 in 2000 samples. In all, 19 non-synonymous single-nucleotide polymorphisms (nsSNPs) were found, 14 in fewer than four subjects (minor allele frequency <0.1%). Lp-PLA2 activity was significantly lower in rare nsSNP carriers compared with non-carriers (167.8±63.2 vs 204.6±41.8, P=0.01) and seven variants had enzyme activities consistent with a null allele. The cumulative frequency of these null alleles was 0.25%, so <1 in 10 000 Europeans would be expected to be homozygous, and thus not potentially benefit from treatment with an Lp-PLA2 inhibitor. [ABSTRACT FROM AUTHOR]

In the system with superconducting quantum interference devices (SQUIDs) in a cavity, we propose a scheme for simultaneous implementing n phase gates and one step preparing the highly entangled cluster states based on the two-channel Raman interaction. In our scheme, the system is independent to the photon number of the cavity field, the cavity field can be initially in an arbitrary state, which is convenient for the experimental operation. The n phase gates operation and the cluster state generation are realized by using only the two lower flux states of the SQUID and the excited state would not be excited so that the influence of the decoherence due to spontaneous emission of the SQUID's levels is possible to minimize. More importantly, the operation time of the phase gates is independent of the number n of the qubits. Finally, the experimental feasibility is also discussed in detail. [ABSTRACT FROM AUTHOR]

In this work, an easy, fast and reliable measurement technique for the quantitative determination of retained fission gases in an irradiated oxide fuel was developed. Many experiments were conducted to determine the optimum conditions for fusion of an oxide fuel, for the quantitative collection and measurements of the released gases. Ion implantation technology was applied to make a krypton or xenon references in a solid matrix. A fragment of oxide fuel, about 0.1 g of an unirradiated SIMFUEL, was completely fused with excess metallic fluxes, 1.0 g of nickel and 1.0 g of tin, in a graphite crucible of a helium atmosphere for 120 s at 850 A as a mixture of metals and alloys. About 96 ± 3 to 98 ± 4% of the krypton and xenon that were injected into the instrument using a standard gas mixture was reproducibly recovered by collecting the releasing gas through the instrument for 120 s. Using the same fusion and collection conditions, it was possible to recover about 97 ± 3% of the injected krypton and xenon by fusing a fragment of SIMFUEL which was wrapped with krypton or xenon implanted aluminum foils. The recovery test results of krypton and xenon using ion planted aluminum foils gave encouraging results suggesting their potential use as a reference specimen. It was confirmed that a fragment of irradiated oxide fuel, 0.051 g, with a code burn-up of 56.9 MWd/MtU, was completely fused as the mixture of metals and alloys through the fusion conditions and more than 99% of the retained fission gases were recovered during the first fusion. Since no cryogenic trap was needed, the collected gas could be measured directly and thus the analysis time could be further reduced. Approximately 7 min was sufficient to finish the measurement of retained fission gases in the irradiated oxide fuel using the developed procedure. [ABSTRACT FROM AUTHOR]

Failure of cisplatin-based chemotherapy in advanced germ cell tumour (GCT) is associated with a poor outcome. High-dose chemotherapy and auto-SCT is one therapeutic option, although the long-term outcome after this procedure is unclear. We conducted a multicentre cohort study of consecutive patients undergoing a single auto-SCT for GCT between January 1986 and December 2004. Of 71 subjects, median follow-up is 10.1 years. OS at 5 years is 44.7% (95% confidence interval (CI) 32.9-56.5%) and EFS is 43.5% (95% CI 31.4-55.1%). There were seven (10%) treatment-related deaths within 100 days of auto-SCT. Three (4.2%) patients developed secondary malignancies. Of 33 relapses, 31 occurred within 2 years of auto-SCT. Two very late relapses were noted 13 and 11 years after auto-SCT. In multivariate analysis, favourable outcome was associated with IGCCC (International Germ Cell Consensus Classification) good prognosis disease at diagnosis, primary gonadal disease and response to salvage chemotherapy. We conclude that auto-SCT results in successful outcome for a relatively large subgroup of patients with high-risk GCT. Late relapses may occur, a finding not previously reported. [ABSTRACT FROM AUTHOR]