Comparison of quality of life after stereotactic body radiotherapy and surgery for early-stage prostate cancer

Background: As the long-term efficacy of stereotactic body radiation therapy (SBRT) becomes established and other prostate cancer treatment approaches are refined and improved, examination of quality of life (QOL) following prostate cancer treatment is critical in driving both patient and clinical treatment decisions. We present the first study to compare QOL after SBRT and radical prostatectomy, with QOL assessed at approximately the same times pre- and post-treatment and using the same validated QOL instrument. Methods: Patients with clinically localized prostate cancer were treated with either radical prostatectomy (n = 123 Spanish patients) or SBRT (n = 216 American patients). QOL was assessed using the Expanded Prostate Cancer Index Composite (EPIC) grouped into urinary, sexual, and bowel domains. For comparison purposes, SBRT EPIC data at baseline, 3 weeks, 5, 11, 24, and 36 months were compared to surgery data at baseline, 1, 6, 12, 24,and 36 months. Differences in patient characteristics between the two groups were assessed using Chi-squared tests for categorical variables and t-tests for continuous variables. Generalized estimating equation (GEE) models were constructed for each EPIC scale to account for correlation among repeated measures and used to assess the effect of treatment on QOL. Results: The largest differences in QOL occurred in the first 16 months after treatment, with larger declines following surgery in urinary and sexual QOL as compared to SBRT, and a larger decline in bowel QOL following SBRT as compared to surgery. Long-term urinary and sexual QOL declines remained clinically significantly lower for surgery patients but not for SBRT patients. Conclusions: Overall, these results may have implications for patient and physician clinical decision making which are often influenced by QOL. These differences in sexual, urinary and bowel QOL should be closely considered in selecting the right treatment, especially in evaluating the value of non-invasive treatments, such as SBRT.

Comparison of quality of life after stereotactic body radiotherapy and surgery for early-stage prostate cancer

Background: As the long-term efficacy of stereotactic body radiation therapy (SBRT) becomes established and other prostate cancer treatment approaches are refined and improved, examination of quality of life (QOL) following prostate cancer treatment is critical in driving both patient and clinical treatment decisions. We present the first study to compare QOL after SBRT and radical prostatectomy, with QOL assessed at approximately the same times pre- and post-treatment and using the same validated QOL instrument. Methods: Patients with clinically localized prostate cancer were treated with either radical prostatectomy (n = 123 Spanish patients) or SBRT (n = 216 American patients). QOL was assessed using the Expanded Prostate Cancer Index Composite (EPIC) grouped into urinary, sexual, and bowel domains. For comparison purposes, SBRT EPIC data at baseline, 3 weeks, 5, 11, 24, and 36 months were compared to surgery data at baseline, 1, 6, 12, 24,and 36 months. Differences in patient characteristics between the two groups were assessed using Chi-squared tests for categorical variables and t-tests for continuous variables. Generalized estimating equation (GEE) models were constructed for each EPIC scale to account for correlation among repeated measures and used to assess the effect of treatment on QOL. Results: The largest differences in QOL occurred in the first 1-6 months after treatment, with larger declines following surgery in urinary and sexual QOL as compared to SBRT, and a larger decline in bowel QOL following SBRT as compared to surgery. Long-term urinary and sexual QOL declines remained clinically significantly lower for surgery patients but not for SBRT patients. Conclusions: Overall, these results may have implications for patient and physician clinical decision making which are often influenced by QOL. These differences in sexual, urinary and bowel QOL should be closely considered in selecting the right treatment, especially in evaluating the value of non-invasive treatments, such as SBRT.

Social capabilities in Alzheimer's patients

Patients with stage-I (very mild and mild) Alzheimer's disease were asked to participate in a Dictator Game, a type of game in which a subject has to decide how to allocate a certain amount of money between himself and another person. The game enables the experimenter to examine the influence of social norms and social preferences on the decision-making process. When the results of treatments involving Alzheimer's disease patients were compared with those of identical treatments involving patients with mild cognitive impairment or healthy control subjects, with similar ages and social backgrounds, no statistically significant difference was found. This finding suggests that stage-I Alzheimer's disease patients may be as capable of making decisions involving social norms and preferences as other individuals of their age. Whatever brain structures are affected by the disease, they do not appear to influence, at this early stage, the neural basis for cooperation-enhancing social interactions.

Social capabilities in Alzheimer’s patients

Patients with stage-I (very mild and mild) Alzheimer s disease were asked to participatein a Dictator Game, a type of game in which a subject has to decide how to allocate acertain amount of money between himself and another person. The game enables theexperimenter to examine the influence of social norms and social preferences on thedecision-making process. When the results of treatments involving Alzheimer s diseasepatients were compared with those of identical treatments involving patients with mildcognitive impairment or healthy control subjects, with similar ages and socialbackgrounds, no statistically significant difference was found. This finding suggests thatstage-I Alzheimer s disease patients may be as capable of making decisions involvingsocial norms and preferences as other individuals of their age. Whatever brain structuresare affected by the disease, they do not appear to influence, at this early stage, the neuralbasis for cooperation-enhancing social interactions.

Perturbing Hele-Shaw flow with a small gap gradient

A controlled perturbation is introduced into the Saffman-Taylor flow problem by adding a gradient to the gap of a Hele-Shaw cell. The stability of the single-finger steady state was found to be strongly affected by such a perturbation. Compared with patterns in a standard Hele-Shaw cell, the single Saffman-Taylor finger was stabilized or destabilized according to the sign of the gap gradient. While a linear stability analysis shows that this perturbation should have a negligible effect on the early-stage pattern formation, the experimental data indicate that the characteristic length for the initial breakup of a flat interface has been changed by the perturbation.

Estudio de la expresión de Stxbp3, Stxbp6 y Claudin F en la formación del lumen en el oído interno del Pez Cebra, Danio rerio

Durante los últimos años se ha fomentado la investigación mediante el pez cebra como modelo biológico gracias a las considerables ventajas que ofrece respecto a modelos utilizados habitualmente. Una de las aplicaciones más destacadas de este modelo es en el estudio de las células sensoriales en el oído interno, ya que tienen un gran parecido con las células sensoriales de los humanos. Gracias a la facilidad de visualización y estudio de estas células en el pez cebra, se han podido llevar a cabo numerosas investigaciones sobre enfermedades que afectan a este órgano sensorial, así como la sordera. No obstante, para poder analizar todas las estructuras y células que forman parte del oído interno, es importante entender la morfogénesis de este órgano. Este proyecto se basa en el estudio de la morfogénesis del oído interno, concretamente, en la formación de lumen, una estructura que se forma en el oído interno en estadios tempranos del embrión, y que a partir de la cual se forman las demás estructuras que constituirán el oído interno. Para poder entender la formación del lumen en estadios tempranos del embrión, es necesario la caracterización de proteínas que participen en este proceso. Por lo que el objetivo principal de este proyecto es el estudio de la de la expresión de los genes Stxbp3, Stxbp6 y Claudin F en la apertura del lumen en el oído interno del pez cebra.

Differences based on fine motor behaviour in Parkinson's patients compared to an age matched control group in proprioceptive and visuo-proprioceptive test conditions

Personality differences based on fine motor precision performance were studied in early stage Parkinson's patients and an age-matched control group under two different test conditions: proprioceptive + visual information and proprioceptive information alone. A comparative data analysis for deviations of three measured movement types (transversal, frontal and sagittal) was done for both hands (dominant and non-dominant) with relation to personality dimensions. There were found significant differences between the two groups in decision making dimension and emotionality. After splitting the data for gender subgroups, some significant differences were found for men but not for women. The differences in fine motor task performance varied, being better in some directions for the Parkinson"s patients and worse in others. The findings may suggest that medication has both positive and negative effects on motor performance and provoke personality changes, being more pronounced in men.

In situ spectroellipsometric study of the nucleation and growth of amorphous silicon

A detailed in situ spectroellipsometric analysis of the nucleation and growth of hydrogenated amorphous silicon (a:Si:H) is presented. Photoelectronic quality a‐Si:H films are deposited by plasma‐enhanced chemical vapor deposition on smooth metal (NiCr alloy) and crystalline silicon (c‐Si) substrates. The deposition of a‐Si:H is analyzed from the first monolayer up to a final thickness of 1.2 μm. In order to perform an improved analysis, real time ellipsometric trajectories are recorded, using fixed preparation conditions, at various photon energies ranging from 2.2 to 3.6 eV. The advantage of using such a spectroscopic experimental procedure is underlined. New insights into the nucleation and growth mechanisms of a‐Si:H are obtained. The nucleation mechanism on metal and c‐Si substrates is very accurately described assuming a columnar microstructural development during the early stage of the growth. Then, as a consequence of the incomplete coalescence of the initial nuclei, a surface roughness at the 10-15 Å scale is identified during the further growth of a‐Si:H on both substrates. The bulk a‐Si:H grows homogeneously beneath the surface roughness. Finally, an increase of the surface roughness is evidenced during the long term growth of a‐Si:H. However, the nature of the substrate influenced the film growth. In particular, the film thickness involved in the nucleation‐coalescence phase is found lower in the case of c‐Si (67±8 Å) as compared to NiCr (118±22 Å). Likewise films deposited on c‐Si present a smaller surface roughness even if thick samples are considered (>1 μm). More generally, the present study illustrates the capability of in situ spectroellipsometry to precisely analyze fundamental processes in thin‐film growth, but also to monitor the preparation of complex structures on a few monolayers scale.

EEG Windowed statitical wavelet deviation for estimation of muscular artifacts

Electroencephalographic (EEG) recordings are, most of the times, corrupted by spurious artifacts, which should be rejected or cleaned by the practitioner. As human scalp EEG screening is error-prone, automatic artifact detection is an issue of capital importance, to ensure objective and reliable results. In this paper we propose a new approach for discrimination of muscular activity in the human scalp quantitative EEG (QEEG), based on the time-frequency shape analysis. The impact of the muscular activity on the EEG can be evaluated from this methodology. We present an application of this scoring as a preprocessing step for EEG signal analysis, in order to evaluate the amount of muscular activity for two set of EEG recordings for dementia patients with early stage of Alzheimer’s disease and control age-matched subjects.

ICA Cleaning procedure for EEG signals analysis: application to Alzheimer's disease detection

To develop systems in order to detect Alzheimer’s disease we want to use EEG signals. Available database is raw, so the first step must be to clean signals properly. We propose a new way of ICA cleaning on a database recorded from patients with Alzheimer's disease (mildAD, early stage). Two researchers visually inspected all the signals (EEG channels), and each recording's least corrupted (artefact-clean) continuous 20 sec interval were chosen for the analysis. Each trial was then decomposed using ICA. Sources were ordered using a kurtosis measure, and the researchers cleared up to seven sources per trial corresponding to artefacts (eye movements, EMG corruption, EKG, etc), using three criteria: (i) Isolated source on the scalp (only a few electrodes contribute to the source), (ii) Abnormal wave shape (drifts, eye blinks, sharp waves, etc.), (iii) Source of abnormally high amplitude ( �100 �V). We then evaluated the outcome of this cleaning by means of the classification of patients using multilayer perceptron neural networks. Results are very satisfactory and performance is increased from 50.9% to 73.1% correctly classified data using ICA cleaning procedure.

HPV & head and neck cancer: a descriptive update

The incidence of head and neck squamous cell carcinoma (HNSCC) has been gradually increasing over the last three decades. Recent data have now attributed a viral aetiology to a subset of head and neck cancers. Several studies indicate that oral human papillomavirus (HPV) infection is likely to be sexually acquired. The dominance of HPV 16 in HPV+ HNSCC is even greater than that seen in cervical carcinoma of total worldwide cases. Strong evidence suggests that HPV+ status is an important prognostic factor associated with a favourable outcome in head and neck cancers. Approximately 30 to 40% of HNSCC patients with present with early stage I/II disease. These patients are treated with curative intent using single modality treatments either radiation or surgery alone. A non-operative approach is favored for patients in which surgery followed by either radiation alone or radiochemotherapy may lead to severe functional impairment. Cetuximab, a humanized mouse anti-EGFR IgG1 monoclonal antibody, improved locoregional control and overall survival in combination with radiotherapy in locally advanced tumours but at the cost of some increased cardiac morbidity and mortality. Finally, the improved prognosis and treatment responses to chemotherapy and radiotherapy by HPV+ tumours may suggest that HPV status detection is required to better plan and individualize patient treatment regimes.