Characterization of PPS Piston and Packing Ring Materials for High-Pressure Hydrogen Applications.

The widespread adoption of renewable energy hinges on the efficient transportation of hydrogen. Reciprocating piston compressor technology in non-lubricated operation will play a key role, ensuring high flow rates and compression ratios. These systems rely on advanced high-strength sealing solutions for piston and rod packing rings utilizing advanced fiber-reinforced polymers. Polyphenylene sulfide (PPS) polymer matrix composites have seen use in tribological applications and promise high mechanical strength and wear resistance. The presented work describes carbon and glass fiber-reinforced PPS matrix polymers in comparison, which are characterized by complementary methods to investigate their properties and potential for application in reciprocating compressor under non-lubricated operation. Thermo-mechanical and tribological testing was supported by microstructure analysis utilizing advanced X-ray and electron imaging techniques. New insights in micromechanical deformation behavior in regard to fiber materials, interface strength and orientation in fiber-reinforced polymers are given. Conclusions on the suitability of different PPS matrix composites for high-pressure hydrogen compression applications were obtained.

[Development of criteria for the prospective assessment of the need for updating guideline recommendations: The AGIL criteria]. / Entwicklung von Kriterien für die prospektive Einschätzung des Aktualisierungsbedarfs von Leitlinienempfehlungen: AGIL-Kriterien.

BACKGROUND: Evidence-based guideline and vaccination recommendations should continuously be updated to appropriately support health care decisions. However, resources for updating guidelines are often limited. The aim of this project was to develop a list of criteria for the prospective assessment of the need for updating individual guideline or vaccination recommendations, which can be applied from the time a guideline or guideline update is finalised. METHODS: In this article we describe the development of the AGIL criteria (Assessment of Guidelines for Updating Recommendations). The AGIL criteria were developed by experienced scientists and experts in the field of guideline development in a multi-step process. The five steps included: 1) development of an initial list of criteria by the project team; 2) online survey of guideline experts on the initial version of the criteria list; 3) revision of the criteria list based on the results of the online survey; 4) workshop on the criteria list at the EbM Congress 2023; 5) creation of version 1.0 of the AGIL criteria based on the workshop results. RESULTS: The initial list included the following three criteria: 1) relevance of the question 2) availability of new relevant evidence, and 3) impact of potentially new evidence. The response rate of the online survey for fully completed questionnaires was 31.0% (N=195; 630 guideline experts were contacted by email). For 90.3% (n=176) of the respondents, the criteria list included all essential aspects for assessing the need for updating guideline recommendations. More than three quarters of respondents rated the importance of the three criteria as "very important" or "important" (criteria 1-3: 75.3%, 86.1%, 85.2%) and - with the exception of criterion 1 - comprehensibility as "very comprehensible" or "comprehensible" (criteria 1-3: 58.4%, 75.9%, 78.5%). The results of the online survey and the workshop generally confirmed the three criteria with their two sub-questions. The incorporation of all feedback resulted in the AGIL criteria (version 1.0), recapping: 1) relevance of the question regarding a) PICO components and b) other factors, e.g. epidemiological aspects; 2) availability of new evidence a) on health-related benefits and harms and b) on other decision factors, e.g. feasibility, acceptability; 3) impact of new evidence a) on the certainty of evidence on which the recommendation is based and b) on the present recommendation, e.g. DISCUSSION: The moderate response rate of the online survey may have limited its representativeness. Nevertheless, we consider the response rate to be satisfactory in this research context. The inclusion of many experts in the online survey and the EbM Congress workshop is a strength of the project and supports the quality of the results. CONCLUSIONS: The AGIL criteria provide a structured guidance for the prospective assessment of the need for updating individual guideline recommendations and other evidence-based recommendations. The implementation and evaluation of the AGIL criteria 1.0 in a field test is planned.

Kinetic and Computational Studies of CO Oxidation and PROX on Cu/CeO2 Nanospheres.

As supported CuO is well-known for low temperature activity, CuO/CeO2 nanosphere catalysts were synthesized and tested for CO oxidation and preferential oxidation of CO (PROX) in excess H2. For the first reaction, ignition was observed at 95 °C, whereas selective PROX occurred in a temperature window from 50 to 100 °C. The catalytic performance was independent of the initial oxidation state of the catalyst (CuO vs. Cu0), suggesting that the same active phase is formed under reaction conditions. Density functional modeling was applied to elucidate the intermediate steps of CO oxidation, as well as those of the comparably less feasible H2 transformation. In the simulations, various Cu and vacancy sites were probed as reactive centers enabling specific pathways. Supplementary Information: The online version contains supplementary material available at 10.1007/s11244-023-01848-x.

Elucidating the role of earth alkaline doping in perovskite-based methane dry reforming catalysts.

To elucidate the role of earth alkaline doping in perovskite-based dry reforming of methane (DRM) catalysts, we embarked on a comparative and exemplary study of a Ni-based Sm perovskite with and without Sr doping. While the Sr-doped material appears as a structure-pure Sm1.5Sr0.5NiO4 Ruddlesden Popper structure, the undoped material is a NiO/monoclinic Sm2O3 composite. Hydrogen pre-reduction or direct activation in the DRM mixture in all cases yields either active Ni/Sm2O3 or Ni/Sm2O3/SrCO3 materials, with albeit different short-term stability and deactivation behavior. The much smaller Ni particle size after hydrogen reduction of Sm1.5Sr0.5NiO4, and of generally all undoped materials stabilizes the short and long-term DRM activity. Carbon dioxide reactivity manifests itself in the direct formation of SrCO3 in the case of Sm1.5Sr0.5NiO4, which is dominant at high temperatures. For Sm1.5Sr0.5NiO4, the CO : H2 ratio exceeds 1 at these temperatures, which is attributed to faster direct carbon dioxide conversion to SrCO3 without catalytic DRM reactivity. As no Sm2O2CO3 surface or bulk phase as a result of carbon dioxide activation was observed for any material - in contrast to La2O2CO3 - we suggest that oxy-carbonate formation plays only a minor role for DRM reactivity. Rather, we identify surface graphitic carbon as the potentially reactive intermediate. Graphitic carbon has already been shown as a crucial reaction intermediate in metal-oxide DRM catalysts and appears both for Sm1.5Sr0.5NiO4 and NiO/monoclinic Sm2O3 after reaction as crystalline structure. It is significantly more pronounced for the latter due to the higher amount of oxygen-deficient monoclinic Sm2O3 facilitating carbon dioxide activation. Despite the often reported beneficial role of earth alkaline dopants in DRM catalysis, we show that the situation is more complex. In our studies, the detrimental role of earth alkaline doping manifests itself in the exclusive formation of the sole stable carbonated species and a general destabilization of the Ni/monoclinic Sm2O3 interface by favoring Ni particle sintering.

Steering the Methane Dry Reforming Reactivity of Ni/La2O3 Catalysts by Controlled In Situ Decomposition of Doped La2NiO4 Precursor Structures.

The influence of A- and/or B-site doping of Ruddlesden-Popper perovskite materials on the crystal structure, stability, and dry reforming of methane (DRM) reactivity of specific A2BO4 phases (A = La, Ba; B = Cu, Ni) has been evaluated by a combination of catalytic experiments, in situ X-ray diffraction, X-ray absorption spectroscopy (XAS), X-ray photoelectron spectroscopy (XPS), and aberration-corrected electron microscopy. At room temperature, B-site doping of La2NiO4 with Cu stabilizes the orthorhombic structure (Fmmm) of the perovskite, while A-site doping with Ba yields a tetragonal space group (I4/mmm). We observed the orthorhombic-to-tetragonal transformation above 170 °C for La2Ni0.9Cu0.1O4 and La2Ni0.8Cu0.2O4, slightly higher than for undoped La2NiO4. Loss of oxygen in interstitial sites of the tetragonal structure causes further structure transformations for all samples before decomposition in the temperature range of 400 °C-600 °C. Controlled in situ decomposition of the parent or A/B-site doped perovskite structures in a DRM mixture (CH4:CO2 = 1:1) in all cases yields an active phase consisting of exsolved nanocrystalline metallic Ni particles in contact with hexagonal La2O3 and a mixture of (oxy)carbonate phases (hexagonal and monoclinic La2O2CO3, BaCO3). Differences in the catalytic activity evolve because of (i) the in situ formation of Ni-Cu alloy phases (in a composition of >7:1 = Ni:Cu) for La2Ni0.9Cu0.1O4, La2Ni0.8Cu0.2O4, and La1.8Ba0.2Ni0.9Cu0.1O4, (ii) the resulting Ni particle size and amount of exsolved Ni, and (iii) the inherently different reactivity of the present (oxy)carbonate species. Based on the onset temperature of catalytic DRM activity, the latter decreases in the order of La2Ni0.9Cu0.1O4 ∼ La2Ni0.8Cu0.2O4 ≥ La1.8Ba0.2Ni0.9Cu0.1O4 > La2NiO4 > La1.8Ba0.2NiO4. Simple A-site doped La1.8Ba0.2NiO4 is essentially DRM inactive. The Ni particle size can be efficiently influenced by introducing Ba into the A site of the respective Ruddlesden-Popper structures, allowing us to control the Ni particle size between 10 nm and 30 nm both for simple B-site and A-site doped structures. Hence, it is possible to steer both the extent of the metal-oxide-(oxy)carbonate interface and its chemical composition and reactivity. Counteracting the limitation of the larger Ni particle size, the activity can, however, be improved by additional Cu-doping on the B-site, enhancing the carbon reactivity. Exemplified for the La2NiO4 based systems, we show how the delicate antagonistic balance of doping with Cu (rendering the La2NiO4 structure less stable and suppressing coking by efficiently removing surface carbon) and Ba (rendering the La2NiO4 structure more stable and forming unreactive surface or interfacial carbonates) can be used to tailor prospective DRM-active catalysts.

Understanding electrochemical switchability of perovskite-type exsolution catalysts.

Exsolution of metal nanoparticles from perovskite-type oxides is a very promising approach to obtain catalysts with superior properties. One particularly interesting property of exsolution catalysts is the possibility of electrochemical switching between different activity states. In this work, synchrotron-based in-situ X-ray diffraction experiments on electrochemically polarized La0.6Sr0.4FeO3-δ thin film electrodes are performed, in order to simultaneously obtain insights into the phase composition and the catalytic activity of the electrode surface. This shows that reversible electrochemical switching between a high and low activity state is accompanied by a phase change of exsolved particles between metallic α--Fe and Fe-oxides. Reintegration of iron into the perovskite lattice is thus not required for obtaining a switchable catalyst, making this process especially interesting for intermediate temperature applications. These measurements also reveal how metallic particles on La0.6Sr0.4FeO3-δ electrodes affect the H2 oxidation and H2O splitting mechanism and why the particle size plays a minor role.

Geographic Distribution of Raccoon Roundworm, Baylisascaris procyonis, Germany and Luxembourg.

Infestation with Baylisascaris procyonis, a gastrointestinal nematode of the raccoon, can cause fatal disease in humans. We found that the parasite is widespread in central Germany and can pose a public health risk. The spread of B. procyonis roundworms into nematode-free raccoon populations needs to be monitored.

[Well informed? Survey results on individual out-of-pocket health services in selected GP practices]. / Gut beraten? Ergebnisse einer Umfrage zu Individuellen Gesundheitsleistungen in ausgewählten Hausarztpraxen.

OBJECTIVES: Patients have to pay out of their own pocket for individual medical services (in German: Individuelle Gesundheitsleistungen, IGeL). The benefit of many IGeL is controversial. Hence, well-founded patient information and counselling are important. For this purpose, several medical organizations and associations developed a checklist including 10 criteria concerning legal and content aspects. Based on this checklist, this study examined how well patients feel informed about IGeL by their doctors. Additionally, we assessed the utilization of IGeL and the attitude of physicians towards IGeL. METHODS: A questionnaire was distributed to 1,000 patients in 20 GP practices in Germany. The data of the patient survey was analyzed descriptively. RESULTS: The response rate to the patient survey was 92.9 %. Of 923 patients, 38 % used at least one IGeL in the last 12 months. The most common IGeL were ultrasound examinations (34 %). Differences were found in compliance with the criteria checklist: In most cases, patients received an invoice (79 %), ad-free information (70 %) and explanations of the medical necessity of the IGeL (70 %). However, physicians have failed to meet these criteria in more than a fifth of respondents. Also, physicians rarely refer to other requirements of the checklist such as, for example, further information and the possibility of obtaining a second opinion. CONCLUSION: This non-representative survey indicates that many patients make use of IGeL. However, they are often not well advised. Physicians should consider criteria of the checklist more rigorously.

Hybrid synthesis of zirconium oxycarbide nanopowders with defined and controlled composition.

A combined synthesis strategy involving a carbothermal reduction and gelation approach with glycine as gelating agent was used to obtain Zr-based (oxy)carbide materials with defined and controlled composition. A comparatively low temperature approach (1500 °C) allows exploration of the ZrC-ZrO2 phase diagram and reproducibly leads to zirconium (oxy)carbide phases with different C/Zr ratios, as confirmed by combined X-ray diffraction (XRD) and transmission electron microscopy (TEM) data. The latter also indicates a chemically very homogeneous distribution of oxygen and carbon throughout the sample bulk, a prerequisite for further characterization of its intrinsic physico-chemical properties. Due to the general variability of the synthesis procedure - variation of metal precursor, amount of gelating agent and carbon precursor source - it is expected that the method can be easily adapted and transferred to other metal - oxycarbide materials.

Fundamentals of cathodoluminescence in a STEM: The impact of sample geometry and electron beam energy on light emission of semiconductors.

Cathodoluminescence has attracted interest in scanning transmission electron microscopy since the advent of commercial available detection systems with high efficiency, like the Gatan Vulcan or the Attolight Mönch system. In this work we discuss light emission caused by high-energy electron beams when traversing a semiconducting specimen. We find that it is impossible to directly interpret the spectrum of the emitted light to the inter-band transitions excited by the electron beam, because the Cerenkov effect and the related light guiding modes as well as transition radiation is altering the spectra. Total inner reflection and subsequent interference effects are changing the spectral shape dependent on the sample shape and geometry, sample thickness, and beam energy, respectively. A detailed study on these parameters is given using silicon and GaAs as test materials.

[Patient involvement in clinical practice guidelines is poor after 12 years of German guideline standards: A review of guideline methodologies]. / Unzureichende Patientenbeteiligung an der Leitlinienentwicklung in Deutschland ­ eine Analyse der von der AWMF verbreiteten ärztlichen Empfehlungen.

BACKGROUND: As early as 1997, the German Guideline for Guidelines laid down patient participation in guideline development as the cornerstone of good, trustworthy medical guidelines. The German Guideline Assessment Tool (DELBI) published in 2005 requires patients or relatives to be involved in the development of medical guidelines. Ideally, this should be effected through membership in the author group. The Association of the Scientific Medical Societies in Germany (AWMF) recommends this approach for the so-called S3 guidelines (systematically developed guidelines) and S2k guidelines (consensus-based guidelines). The present study addresses the question of whether and to what extent German guideline publishers adhere to these principles of patient orientation. METHODS: For this purpose, a descriptive analysis of the guidelines valid at the beginning of November 2017 was carried out. All guidelines (n=520) of the AWMF member societies were assessed. We evaluated S3- and S2k guidelines only, as these are of particular importance for patient involvement due to the requirement of an interdisciplinary guideline group. Data were reported on the involvement of patients (as co-authors of medical guidelines) and on the existence of guidance documents addressing patients and the public (so-called patient information and patient guidelines). RESULTS: Regarding the 105 (165) S3 (S2k) guidelines, we found evidence on patient involvement in guideline development in 99 (134) cases (94 % of S3 / 81 % of S2k guidelines). In 61 (87) guidelines, authors had contributed to the authors group (58 % / 53 %) and 59 (80) guidelines with voting rights (56 % / 48 %). For 50 (15) S3 (S2k) guidelines (48 % / 9 %), the guideline report provided information on the existence or planned development of guidance documents for patients and the public (patient guidelines or patient information). Guidance-related patient information was available on the internet for only 37 (2) S3 (S2k) guidelines (35 % / 2 %). CONCLUSION: A substantial gap remains between patient / public involvement standards for guideline development and practice in Germany, even 12 years after the publication of national guideline standards. This is a missed opportunity since guidelines without adequate participation of those affected by the recommendations have a problem of legitimacy and transparency. Only guidelines where patients were involved in all voting processes during development build and strengthen trust between patients and the medical profession. And only those who present the rationale for medical recommendations in a generally understandable and comprehensible manner let affected individuals make individual decisions.

A Miniaturized Extruder to Prototype Amorphous Solid Dispersions: Selection of Plasticizers for Hot Melt Extrusion.

Hot-melt extrusion is an option to fabricate amorphous solid dispersions and to enhance oral bioavailability of poorly soluble compounds. The selection of suitable polymer carriers and processing aids determines the dissolution, homogeneity and stability performance of this solid dosage form. A miniaturized extrusion device (MinEx) was developed and Hypromellose acetate succinate type L (HPMCAS-L) based extrudates containing the model drugs neurokinin-1 (NK1) and cholesterylester transfer protein (CETP) were manufactured, plasticizers were added and their impact on dissolution and solid-state properties were assessed. Similar mixtures were manufactured with a lab-scale extruder, for face to face comparison. The properties of MinEx extrudates widely translated to those manufactured with a lab-scale extruder. Plasticizers, Polyethyleneglycol 4000 (PEG4000) and Poloxamer 188, were homogenously distributed but decreased the storage stability of the extrudates. Stearic acid was found condensed in ultrathin nanoplatelets which did not impact the storage stability of the system. Depending on their distribution and physicochemical properties, plasticizers can modulate storage stability and dissolution performance of extrudates. MinEx is a valuable prototyping-screening method and enables rational selection of plasticizers in a time and material sparing manner. In eight out of eight cases the properties of the extrudates translated to products manufactured in lab-scale extrusion trials.

[Short information leaflets for patients - a service offered to physicians: Early implementation experiences]. / Kurzinformationen für Patienten (KiP) als Service-Angebot für Ärztinnen und Ärzte - erste Erfahrungen mit der Implementierung.

Since 2010, the German Agency for Quality in Medicine has developed so-called short information leaflets for patients that are specifically designed for use in doctor-patient encounters. Physicians, patient representatives and communication specialists were involved in the development of this format. Their implementation aims at enhancing awareness and dissemination of these leaflets amongst the members of the self-governing bodies and other multipliers (like medical specialty societies, patient organisations, other bodies and institutions of the healthcare system). This paper describes the first implementation experiences on the basis of internally collected data on the involvement of multipliers, availability and assessment of their relevance. A first analysis shows that the short information leaflets are broadly available amongst the self-governing bodies and that they are considered to be of high relevance. Due to the direct involvement of the members of specialty societies and patient organisations and other experts, short information leaflets are also gaining acceptance outside the self-governing system. This is emphasised by the rising number of requests to reprint or cite or use the leaflets. Consistency with evidence-based treatment recommendations promotes acceptance of these leaflets among physicians.

[The raccoon roundworm (Baylisascaris procyonis)--no zoonotic risk for Brandenburg?]. / Der Waschbärspulwurm (Baylisascaris procyonis)--kein Zoonoserisiko für Brandenburg?

The aim of the present study was to investigate the presence of the raccoon roundworm (Baylisascaris [B.] procyonis), a dangerous zoonotic pathogen for humans, in raccoons living in the federal state of Brandenburg, Germany. In the years 2008 to 2013, a total of 762 raccoons, dating from hunting bags, were examined for intestinal helminths. No raccoon roundworm specimen was detected, but 27 samples were positive for Mesocestoides spp. Earlier studies had proved the presence of B. procyonis in Hesse and since 2005 the parasite has also been found in the western part of Saxony-Anhalt. The migration ability of raccoons may promote a further distribution of this parasite and could increase the risk for zoonotic infections in humans.

Influence of reproductive history and exogenous hormone use on prevalence and frequency of circulating t(14;18)-positive cells in a population-based cross-sectional study.

PURPOSE: The t(14;18) translocation might represent an intermediate step in the pathogenesis of follicular lymphoma (FL), one of the most common subtypes of non-Hodgkin lymphoma. Circulating t(14;18)-positive cells can also be detected in 30-60 % of healthy individuals at low frequencies. Some studies found a negative association between reproductive factors or use of menopausal hormone therapy (MHT) with FL. The objective of this study was to evaluate whether there is an association between number of frequencies, oral contraceptive (OC) use, menopausal status and MHT, and t(14;18) prevalence and frequency in a representative population analysis based on an epidemiologic study in the northeastern part of Germany. METHODS: The analysis is based on results of buffy coat samples from 1,981 women of the Study of Health in Pomerania (SHIP-0) and data obtained in standardized face-to-face interviews. For prevalence, odds ratios (OR) and 95 % confidence intervals (CI) were calculated using unconditional logistic regression. Frequency data were analyzed using negative binomial regression. The multivariable models included age, number of pregnancies, menopausal status (premenopausal, natural, medical/surgical menopause), OC use and MHT as a measure for exogenous hormone exposure use. RESULTS: We found no association between reproductive history and combined exogenous hormone use on the prevalence of circulating t(14;18)-positive cells. Modeling MHT and OC use separately in a sensitivity analysis, the MHT parameter yielded statistical significance [OR 1.37 (95 % CI 1.04;1.81)]. t(14;18) frequency was associated with use of OC [incidence rate ratio (IRR) for ever use 3.18 (95 % CI 1.54;6.54)], current use [IRR 3.86 (1.56;9.54)], >10 years use [IRR 3.93 (1.67;9.23)] and MHT [restricted to postmenopausal women; IRR 2.63 (95 % CI 1.01;6.85)] in bivariate age-adjusted analyses. In the multivariable model, medical/surgical menopause [IRR 2.46 (1.11;5.44)] and the category ever use of OC and MHT were statistically significant [IRR 2.41 (1.09;5.33)]. CONCLUSIONS: Exogenous hormone use might be a risk factor for t(14;18) frequency rather than for t(14;18) prevalence. Further research on healthy individuals carrying a t(14;18) translocation and possible risk factors for malignant lymphoma is necessary to determine the additional molecular or immunological events that have to occur to develop FL.

The biological potential of the raccoon dog (Nyctereutes procyonoides, Gray 1834) as an invasive species in Europe-new risks for disease spread?

Invasive wildlife species have the potential to act as additional host and vector species for infectious diseases. The raccoon dog (Nyctereutes procyonides), a carnivore species that has its origin in Asia, was taken as an example to demonstrate biological and ecological prerequisites which enables an invasive species to occupy a new habitat permanently. Studies conducted during the last 20 years identified a total of 35 species of endoparasites, five ectoparasites, six bacterial or protozoan species, and five viruses found in the subspecies Nyctereutes procyonoides ussuriensis in its original and newly occupied habitat or in Nyctereutes procyonoides koreensis in its original habitat, respectively. With reference to raccoon dogs impact as vector species and the relevance for human and animal health, we selected Trichinella spp., Echinococcus multilocularis, Francisella tularensis, rabies virus, and canine distemper virus for detailed description. Results of studies from Finland and Germany furthermore showed that biological characteristics of the raccoon dog make this carnivore an ideal host and vector for a variety of pathogens. This may result in a growing importance of this invasive species concerning the epidemiology of some transmissible diseases in Europe, including the hazard that the existence of autochthonous wildlife, particularly small populations, is endangered. Potential adverse effects on human and animal health in the livestock sector must also be taken into account. Especially with regard to its potential as a reservoir for zoonotic diseases, the raccoon dog should receive more attention in disease prevention and eradication strategies.

Impact of high-risk cytogenetics and achievement of molecular remission on long-term freedom from disease after autologous-allogeneic tandem transplantation in patients with multiple myeloma.

Within a prospective protocol, the incidence and impact of achievement of molecular remission (mCR) and high-risk cytogenetics was investigated in 73 patients with multiple myeloma (MM) after autologous (auto)-allogeneic (allo) tandem stem cell transplantation (SCT). After induction chemotherapy, patients received melphalan 200 mg/m(2) before undergoing auto-SCT, followed 3 months later by melphalan 140 mg/m(2) and fludarabine 180 mg/m(2) before allo-SCT. Sixteen patients had high-risk cytogenetic features, defined by positive FISH for del(17p13) and/or t(4;14). Overall, 66% of the patients achieved CR or near-CR, and 41% achieved mCR, which was sustained negative (at least 4 consecutive samples negative) in 15 patients (21%), with no significant difference in incidence between the patients with high-risk cytogenetics and others (P = .70). After a median follow-up of 6 years, overall 5-year progression-free survival was 29%, with no significant difference between del 17p13/t(4;14)-harboring patients and others (24% versus 30%; P = .70). The 5-year progression-free survival differed substantially according to the achieved remission: 17% for partial remission, 41% for CR, 57% for mCR, and 85% for sustained mCR. These results suggest that auto-allo tandem SCT may overcome the negative prognostic effect of del(17p13) and/or t(4;14) and that achievement of molecular remission resulted in long-term freedom from disease.