Optimisation of radiotherapy for carcinoma of the parotid gland: a comparison of conventional, three-dimensional conformal, and intensity-modulated techniques

Background and purpose: To compare external beam radiotherapy techniques for parotid gland tumours using conventional radiotherapy (RT), three-dimensional conformal radiotherapy (3DCRT), and intensity-modulated radiotherapy (IMRT). To optimise the IMRT techniques, and to produce an IMRT class solution.Materials and methods: The planning target volume (PTV), contra-lateral parotid gland, oral cavity, brain-stem, brain and cochlea were outlined on CT planning scans of six patients with parotid gland tumours. Optimised conventional RT and 3DCRT plans were created and compared with inverse-planned IMRT dose distributions using dose-volume histograms. The aim was to reduce the radiation dose to organs at risk and improve the PTV dose distribution. A beam-direction optimisation algorithm was used to improve the dose distribution of the IMRT plans, and a class solution for parotid gland IMRT was investigated.Results: 3DCRT plans produced an equivalent PTV irradiation and reduced the dose to the cochlea, oral cavity, brain, and other normal tissues compared with conventional RT. IMRT further reduced the radiation dose to the cochlea and oral cavity compared with 3DCRT. For nine- and seven-field IMRT techniques, there was an increase in low-dose radiation to non-target tissue and the contra-lateral parotid gland. IMRT plans produced using three to five optimised intensity-modulated beam directions maintained the advantages of the more complex IMRT plans, and reduced the contra-lateral parotid gland dose to acceptable levels. Three- and four-field non-coplanar beam arrangements increased the volume of brain irradiated, and increased PTV dose inhomogeneity. A four-field class solution consisting of paired ipsilateral coplanar anterior and posterior oblique beams (15, 45, 145 and 170o from the anterior plane) was developed which maintained the benefits without the complexity of individual patient optimisation.Conclusions: For patients with parotid gland tumours, reduction in the radiation dose to critical normal tissues was demonstrated with 3DCRT compared with conventional RT. IMRT produced a further reduction in the dose to the cochlea and oral cavity. With nine and seven fields, the dose to the contra-lateral parotid gland was increased, but this was avoided by optimisation of the beam directions. The benefits of IMRT were maintained with three or four fields when the beam angles were optimised, but were also achieved using a four-field class solution. Clinical trials are required to confirm the clinical benefits of these improved dose distributions.

Le transfert de documents conformes et la résolution du contrat pour leur non-conformité selon la convention de Vienne sur la vente internationale de marchandises

La présente étude examine une des difficultés que soulève l'exécution des contrats de vente mettant en relation des parties situées dans des pays différents. Ces contrats connaissent des problèmes bien particuliers. En effet, en donnant lieu à l'expédition des marchandises vendues, ces contrats obligent aussi le vendeur à transférer à l'acheteur les documents conformes représentatifs de celles-ci. La non-conformité des documents se distingue de la non-conformité des marchandises et constitue une source principale des litiges visant la résolution des contrats dans ce secteur commercial. La diversité des solutions susceptibles de s'y appliquer est devenue une réalité depuis que les droits internes doivent coexister avec les règles de la Convention de Vienne sur la vente internationale de marchandises. En principe, aucune difficulté ne se pose lorsqu'un droit interne est désigné comme étant le droit compétent: il suffirait d'appliquer les solutions de ce droit. Ainsi, par exemple, l'acheteur peut résoudre le contrat si les documents ne sont pas conformes aux stipulations contractuelles sur la base du concept de fundamental breach (en cas de vente non documentaire) ou sur la base de la stricte conformité (en cas de vente documentaire) que retiennent les droits anglo-américain; en revanche dans les systèmes de droit civil (où la distinction entre vente documentaire et vente non documentaire n'existe pas), pareille résolution du contrat basée sur le défaut de conformité des documents n'est possible qu'en présence d'un préjudice important ou d'un défaut majeur. Plusieurs justifications fondamentales sous-tendent la raison d'être des solutions retenues par les droits nationaux: quête de sécurité juridique et recherche de solution conforme aux besoins des opérateurs du commerce international. Néanmoins, il appert que de telles justifications sont également présentes dans la Convention de Vienne. De plus, cette Convention oblige le vendeur à transférer à l'acheteur les documents conformes de la vente. Cependant, elle le fait de manière indirecte sans pour autant préciser quels types de documents doivent faire l'objet du transfert. L'opportunité d'un tel transfert dépendra donc, sous réserves des dispositions impératives, de l'accord des parties et des usages commerciaux qui ont préséance sur les règles unifiées. Ce qui en fait parfois une question d'interprétation du contrat ou une question de comblement des lacunes de ce droit uniforme de la vente internationale. En ce sens, ce dernier droit diffère des droits nationaux qui sont plus clairs à cet égard. Quant aux conditions de la résolution du contrat pour non-conformité des documents, quel que soit le système national considéré, la solution qu'il consacre contraste avec celle prévue par la Convention de Vienne qui n'admet une telle sanction qu'en présence d'une contravention essentielle. Cette dualité entre droits nationaux et droit matériel uniforme nous met en face d'un constat bien évident: l'avènement de la Convention de Vienne sur la vente internationale de marchandises et la règle de la contravention essentielle qu'elle consacre, perturbent le paysage juridique jusqu'ici en vigueur dans chacun des États signataires. Ce qui justifie tout l'intérêt du sujet: la contravention essentielle par opposition à la règle de la stricte conformité et celle basée sur l'importance du préjudice prévues par les droits internes sont-elles des règles exclusives l'une de l'autre? La réponse est loin d'être certaine en dépit des convergences possibles dans le dénouement du contentieux de la résolution, même si par ailleurs il faut admettre qu'il s'agit de régimes juridiques bien différents. Tout en subordonnant la résolution du contrat à l'existence d'une contravention essentielle, lorsque la Convention de Vienne s'applique (DEUXIÈME PARTIE), la présente étude propose une interprétation de celle-ci en examinant son contenu ainsi que les différentes sources qui interfèrent dans sa mise en œuvre afin de démontrer que ce droit uniforme, malgré ses limites, régit les aspects documentaires de la vente internationale (PREMIÈRE PARTIE).

La perception du rôle et les attitudes de cynisme et de désengagement chez le technicien ambulancier paramédic québécois dans le contexte des interventions non urgentes

Problématique : Le rôle des paramédics se transforme partout dans le monde. Les besoins des aînés et des malades chroniques entraînent une forte proportion d’interventions préhospitalières non urgentes. La confrontation entre la perception et l’expérience du rôle peut entraîner un conflit correspondant à un stress organisationnel modéré et chronique chez ces travailleurs. Pour y faire face, différentes stratégies d’adaptation peuvent être adoptées. Objectifs : Cette étude vise à dépeindre la réalité des interventions préhospitalières non urgentes des paramédics québécois et à explorer son influence sur leur perception du rôle et les manifestations de cynisme et de désengagement. Méthode : Les données qualitatives obtenues en entrevues semi-structurées ont été codifiées et analysées à partir d’un modèle adapté des théories en psychosociologie du travail et d’administration de la santé (n=13, 3 régions, intervenants de - de 3 à + de 20 ans de carrière). Résultats : Les paramédics reconnaissent vivre un conflit de rôle alors que la formation et la définition de leur pratique se rapportent exclusivement à l’urgence, au contraire de leur expérience. Ils manifestent des attitudes de cynisme et de désengagement affectant la qualité des services, précisant qu’il s’agit d’une réalité inhérente à leur expérience professionnelle intimement reliée à l’épuisement professionnel, plus qu’à un manque fondamental de professionnalisme. Conclusion : Les paramédics décrivent différents mécanismes à instaurer qui visent à reconnaître la dualité conflictuelle de leur pratique dont, la mise en valeur de leur aptitude clinique à intervenir en première ligne dans un cadre préhospitalier non urgent ainsi que l’ajustement et le rehaussement des programmes de formation.

Fermion perturbations in string theory black holes

In this paper we study fermion perturbations in four-dimensional black holes of string theory, obtained either from a non-extreme configuration of three intersecting five-branes with a boost along the common string or from a non-extreme intersecting system of two two-branes and two five-branes. The Dirac equation for the massless neutrino field, after conformal re-scaling of the metric, is written as a wave equation suitable to study the time evolution of the perturbation. We perform a numerical integration of the evolution equation, and with the aid of Prony fitting of the time-domain profile, we calculate the complex frequencies that dominate the quasinormal ringing stage, and also determine these quantities by the semi-analytical sixth-order WKB method. We also find numerically the decay factor of fermion fields at very late times, and show that the falloff is identical to those showing for massless fields in other four-dimensional black hole spacetimes.

A conformal invariant growth model

We present a one-parameter extension of the raise and peel one-dimensional growth model. The model is defined in the configuration space of Dyck (RSOS) paths. Tiles from a rarefied gas hit the interface and change its shape. The adsorption rates are local but the desorption rates are non-local; they depend not only on the cluster hit by the tile but also on the total number of peaks (local maxima) belonging to all the clusters of the configuration. The domain of the parameter is determined by the condition that the rates are non-negative. In the finite-size scaling limit, the model is conformal invariant in the whole open domain. The parameter appears in the sound velocity only. At the boundary of the domain, the stationary state is an adsorbing state and conformal invariance is lost. The model allows us to check the universality of non-local observables in the raise and peel model. An example is given.

Generalized duality between local vector theories in D=2+1

The existence of an interpolating master action does not guarantee the same spectrum for the interpolated dual theories. In the specific case of a generalized self-dual (GSD) model defined as the addition of the Maxwell term to the self-dual model in D = 2 + 1, previous master actions have furnished a dual gauge theory which is either nonlocal or contains a ghost mode. Here we show that by reducing the Maxwell term to first order by means of an auxiliary field we are able to define a master action which interpolates between the GSD model and a couple of non-interacting Maxwell-Chern-Simons theories of opposite helicities. The presence of an auxiliary field explains the doubling of fields in the dual gauge theory. A generalized duality transformation is defined and both models can be interpreted as self-dual models. Furthermore, it is shown how to obtain the gauge invariant correlators of the non-interacting MCS theories from the correlators of the self-dual field in the GSD model and vice-versa. The derivation of the non-interacting MCS theories from the GSD model, as presented here, works in the opposite direction of the soldering approach.

Some experiments with high order compact methods using a computer algebra software - Part II (non-uniform grid)

We generalize a procedure proposed by Mancera and Hunt [P.F.A. Mancera, R. Hunt, Some experiments with high order compact methods using a computer algebra software-Part 1, Appl. Math. Comput., in press, doi: 10.1016/j.amc.2005.05.015] for obtaining a compact fourth-order method to the steady 2D Navier-Stokes equations in the streamfunction formulation-vorticity using the computer algebra system Maple, which includes conformal mappings and non-uniform grids. To analyse the procedure we have solved a constricted stepped channel problem, where a fine grid is placed near the re-entrant corner by transformation of the independent variables. (c) 2006 Elsevier B.V. All rights reserved.

SU(2,R)(q) symmetries of Non-Abelian Toda theories

The classical and quantum algebras of a class of conformal NA-Toda models are studied. It is shown that the SL(2,R)(q) Poisson brackets algebra generated by certain chiral and antichiral charges of the nonlocal currents and the global U(1) charge appears as an algebra of the symmetries of these models. (C) 1998 Elsevier B.V. B.V. All rights reserved.

Bicomplexes and conservation laws in non-Abelian Toda models

A bicomplex structure is associated with the Leznov-Saveliev equation of integrable models. The linear problem associated with the zero-curvature condition is derived in terms of the bicomplex linear equation. The explicit example of a non-Abelian conformal affine Toda model is discussed in detail and its conservation laws are derived from the zero-curvature representation of its equation of motion.

T-duality of axial and vector dyonic integrable models

A general construction of affine nonabelian (NA)-Toda models in terms of the axial and vector gauged two loop WZNW model is discussed. They represent integrable perturbations of the conformal sigma -models (with tachyons included) describing (charged) black hole type string backgrounds. We study the off-critical T-duality between certain families of axial and vector type integrable models for the case of affine NA-Toda theories with one global U(1) symmetry. In particular we find the Lie algebraic condition defining a subclass of T-selfdual torsionless NA-Toda models and their zero curvature representation. (C) 2001 Academic Press.

Duality in noncommutative topologically massive gauge field theory revisited

We introduce a master action in non-commutative space, out of which we obtain the action of the non-commutative Maxwell-Chern-Simons theory. Then, we look for the corresponding dual theory at both first and second order in the non-commutative parameter. At the first order, the dual theory happens to be, precisely, the action obtained from the usual commutative self-dual model by generalizing the Chern-Simons term to its non-commutative version, including a cubic term. Since this resulting theory is also equivalent to the non-commutative massive Thirring model in the large fermion mass limit, we remove, as a byproduct, the obstacles arising in the generalization to non-commutative space, and to the first non-trivial order in the non-commutative parameter, of the bosonization in three dimensions. Then, performing calculations at the second order in the non-commutative parameter, we explicitly compute a new dual theory which differs from the non-commutative self-dual model and, further, differs also from other previous results and involves a very simple expression in terms of ordinary fields. In addition, a remarkable feature of our results is that the dual theory is local, unlike what happens in the non-Abelian, but commutative case. We also conclude that the generalization to non-commutative space of bosonization in three dimensions is possible only when considering the first non-trivial corrections over ordinary space.

Confinement, solitons and the equivalence between the sine-Gordon and massive Thirring models

We consider a two-dimensional integrable and conformally invariant field theory possessing two Dirac spinors and three scalar fields. The interaction couples bilinear terms in the spinors to exponentials of the scalars. Its integrability properties are based on the sl(2) affine Kac-Moody algebra, and it is a simple example of the so-called conformal affine Toda theories coupled to matter fields. We show, using bosonization techniques, that the classical equivalence between a U(1) Noether current and the topological current holds true at the quantum level, and then leads to a bag model like mechanism for the confinement of the spinor fields inside the solitons. By bosonizing the spinors we show that the theory decouples into a sine-Gordon model and free scalars. We construct the two-soliton solutions and show that their interactions lead to the same time delays as those for the sine-Gordon solitons. The model provides a good laboratory to test duality ideas in the context of the equivalence between the sine-Gordon and Thirring theories. © 2000 Elsevier Science B.V. All rights reserved.

Integrability and conformal symmetry in higher dimensions: A model with exact hopfion solutions

We use ideas on integrability in higher dimensions to define Lorentz invariant field theories with an infinite number of local conserved currents. The models considered have a two-dimensional target space. Requiring the existence of lagrangean and the stability of static solutions singles out a class of models which have an additional conformal symmetry. That is used to explain the existence of an ansatz leading to solutions with non-trivial Hopf charges. © SISSA/ISAS 2002.

Non-perturbative fixed points and renormalization group improved effective potential

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Gaiotto duality for the twisted A(2N-1) series

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)