High-hemorrhagic early death (ED) rate is a major impediment in the managing of acute promyelocytic leukemia (APL). In our group of 56 newly diagnosed APL patients, ED occurred in 12 subjects, due to endocranial bleeding (8/12), differentiation syndrome (2/12), or infection (2/12). Predictors of hemorrhagic ED were as follows: white blood cells count ≥ 20 × 10(9)/L (P = 0.002337), Eastern cooperative oncology group performance status ≥ 3 (P = 0.00173), fibrinogen level <2 g/L (P = 0.004907), prothrombin time <50% (P = 0.0124), and International Society of Thrombosis and Hemostasis Scoring System for disseminated intravascular coagulation (ISTH DIC score) ≥ 6 (P = 0.00741). Multivariate analysis indicated ISTH DIC score ≥ 6 to be the most significant predictor for hemorrhagic ED (P = 0.008). The main finding of this study is that simple coagulation-related tests, performed on hospital admission and combined in the ISTH DIC score, might help to identify patients at high risk for fatal bleeding needing more aggressive supportive measures.
Phenol-resorcinol-formaldehyde (PRF) and one-component polyurethane (PUR) resins were used to manufacture single lap joint samples corresponding to EN 302-1. 3D electronic speckle pattern interferometry (ESPI), which enables measurement of spatial displacement of less than 0.1 mm, was used during tensile shear experiments to observe full-field in-plane and out-of-plane deformation of the lap joint samples and to detect strain concentrations in the vicinity of glue lines. Finite element analysis was performed to validate ESPI measurements. In general, ESPI measurements showed that in a lap joint experiment a very small volume of material close to the ends of the overlapping area is highly strained. ESPI and finite element analysis pointed out that PUR glue lines are characterised by much higher shear deformations than PRF glue lines, especially at the ends of the overlapping area. However, due to the lower Young's modulus of PUR resin compared to PRF, higher shear strains but lower shear stress concentrations can be expected in PUR, which was confirmed by the FE model.
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