Conventional versus hypofractionated high-dose intensity-modulated radiotherapy for prostate cancer: 5-year outcomes of the randomised, non-inferiority, phase 3 CHHiP trial

BACKGROUND: Prostate cancer might have high radiation-fraction sensitivity that would give a therapeutic advantage to hypofractionated treatment. We present a pre-planned analysis of the efficacy and side-effects of a randomised trial comparing conventional and hypofractionated radiotherapy after 5 years follow-up.

METHODS: CHHiP is a randomised, phase 3, non-inferiority trial that recruited men with localised prostate cancer (pT1b-T3aN0M0). Patients were randomly assigned (1:1:1) to conventional (74 Gy delivered in 37 fractions over 7·4 weeks) or one of two hypofractionated schedules (60 Gy in 20 fractions over 4 weeks or 57 Gy in 19 fractions over 3·8 weeks) all delivered with intensity-modulated techniques. Most patients were given radiotherapy with 3-6 months of neoadjuvant and concurrent androgen suppression. Randomisation was by computer-generated random permuted blocks, stratified by National Comprehensive Cancer Network (NCCN) risk group and radiotherapy treatment centre, and treatment allocation was not masked. The primary endpoint was time to biochemical or clinical failure; the critical hazard ratio (HR) for non-inferiority was 1·208. Analysis was by intention to treat. Long-term follow-up continues. The CHHiP trial is registered as an International Standard Randomised Controlled Trial, number ISRCTN97182923.

FINDINGS: Between Oct 18, 2002, and June 17, 2011, 3216 men were enrolled from 71 centres and randomly assigned (74 Gy group, 1065 patients; 60 Gy group, 1074 patients; 57 Gy group, 1077 patients). Median follow-up was 62·4 months (IQR 53·9-77·0). The proportion of patients who were biochemical or clinical failure free at 5 years was 88·3% (95% CI 86·0-90·2) in the 74 Gy group, 90·6% (88·5-92·3) in the 60 Gy group, and 85·9% (83·4-88·0) in the 57 Gy group. 60 Gy was non-inferior to 74 Gy (HR 0·84 [90% CI 0·68-1·03], pNI=0·0018) but non-inferiority could not be claimed for 57 Gy compared with 74 Gy (HR 1·20 [0·99-1·46], pNI=0·48). Long-term side-effects were similar in the hypofractionated groups compared with the conventional group. There were no significant differences in either the proportion or cumulative incidence of side-effects 5 years after treatment using three clinician-reported as well as patient-reported outcome measures. The estimated cumulative 5 year incidence of Radiation Therapy Oncology Group (RTOG) grade 2 or worse bowel and bladder adverse events was 13·7% (111 events) and 9·1% (66 events) in the 74 Gy group, 11·9% (105 events) and 11·7% (88 events) in the 60 Gy group, 11·3% (95 events) and 6·6% (57 events) in the 57 Gy group, respectively. No treatment-related deaths were reported.

INTERPRETATION: Hypofractionated radiotherapy using 60 Gy in 20 fractions is non-inferior to conventional fractionation using 74 Gy in 37 fractions and is recommended as a new standard of care for external-beam radiotherapy of localised prostate cancer.

FUNDING: Cancer Research UK, Department of Health, and the National Institute for Health Research Cancer Research Network.

Finite Sampling Exponential Bounds

Thesis (Ph.D.)--University of Washington, 2016-08

Differences in grain growth of calcite: a field-based modeling approach

Normal grain growth of calcite was investigated by combining grain size analysis of calcite across the contact aureole of the Adamello pluton, and grain growth modeling based on a thermal model of the surroundings of the pluton. In an unbiased model system, i.e., location dependent variations in temperature-time path, 2/3 and 1/3 of grain growth occurs during pro- and retrograde metamorphism at all locations, respectively. In contrast to this idealized situation, in the field example three groups can be distinguished, which are characterized by variations in their grain size versus temperature relationships: Group I occurs at low temperatures and the grain size remains constant because nano-scale second phase particles of organic origin inhibit grain growth in the calcite aggregates under these conditions. In the presence of an aqueous fluid, these second phases decay at a temperature of about 350 °C enabling the onset of grain growth in calcite. In the following growth period, fluid-enhanced group II and slower group III growth occurs. For group II a continuous and intense grain size increase with T is typical while the grain growth decreases with T for group III. None of the observed trends correlate with experimentally based grain growth kinetics, probably due to differences between nature and experiment which have not yet been investigated (e.g., porosity, second phases). Therefore, grain growth modeling was used to iteratively improve the correlation between measured and modeled grain sizes by optimizing activation energy (Q), pre-exponential factor (k0) and grain size exponent (n). For n=2, Q of 350 kJ/mol, k0 of 1.7×1021 μmns−1 and Q of 35 kJ/mol, k0 of 2.5×10-5 μmns−1 were obtained for group II and III, respectively. With respect to future work, field-data based grain growth modeling might be a promising tool for investigating the influences of secondary effects like porosity and second phases on grain growth in nature, and to unravel differences between nature and experiment.

NB-IoT via non terrestrial networks

Massive Internet of Things is expected to play a crucial role in Beyond 5G (B5G) wireless communication systems, offering seamless connectivity among heterogeneous devices without human intervention. However, the exponential proliferation of smart devices and IoT networks, relying solely on terrestrial networks, may not fully meet the demanding IoT requirements in terms of bandwidth and connectivity, especially in areas where terrestrial infrastructures are not economically viable. To unleash the full potential of 5G and B5G networks and enable seamless connectivity everywhere, the 3GPP envisions the integration of Non-Terrestrial Networks (NTNs) into the terrestrial ones starting from Release 17. However, this integration process requires modifications to the 5G standard to ensure reliable communications despite typical satellite channel impairments. In this framework, this thesis aims at proposing techniques at the Physical and Medium Access Control layers that require minimal adaptations in the current NB-IoT standard via NTN. Thus, firstly the satellite impairments are evaluated and, then, a detailed link budget analysis is provided. Following, analyses at the link and the system levels are conducted. In the former case, a novel algorithm leveraging time-frequency analysis is proposed to detect orthogonal preambles and estimate the signals’ arrival time. Besides, the effects of collisions on the detection probability and Bit Error Rate are investigated and Non-Orthogonal Multiple Access approaches are proposed in the random access and data phases. The system analysis evaluates the performance of random access in case of congestion. Various access parameters are tested in different satellite scenarios, and the performance is measured in terms of access probability and time required to complete the procedure. Finally, a heuristic algorithm is proposed to jointly design the access and data phases, determining the number of satellite passages, the Random Access Periodicity, and the number of uplink repetitions that maximize the system's spectral efficiency.

Indicadores dermatoglificos de aptidão fisica e efeito dos treinamentos intervalado versus continuo na pratica da corrida em piscina funda : intervenção com mulheres obesas

Universidade Estadual de Campinas . Faculdade de Educação Física

Time resolved emission spectroscopy of poly(2,5-dicyano-p-phenylene-vinylene) films

Films of poly (2,5-dicyano-p-phenylene vinylene), DCNPPV, were obtained by electrochemical synthesis over gold thin layer (20 nm) transparent electrode deposited on a glass plate. The DCNPPV films of 4 µm thickness were produced by electropolymerization process of α,α,α',α'-tetrabromo-2-5-dicyano-p-xilene at different applied potentials (-0.15, -0.25, -0.40, -0.60, -0.80, and -1.0 V) using 0.1 mol L-1 of tetraethylammonium bromide in acetonitrile as the supporting electrolyte. The emission decays have three exponential components: a fast component in the picosecond range (200-400 ps), and two other of about one and five nanoseconds at 293 K. The fluorescence quenching process seems to occur by exciton trapping in a low-energy site and quenching by residual bromine monomer attached at the end of the polymer chain. However, the electrochemical synthesis generates entrapped bromide or ion pairs during the growth step of the film which also contributes to the deactivation. The change of the electrolyte from bromide to perchlorate reduces significantly this additional quenching effect by allowing ion exchange of formed bromide with the nonquenching perchloride anion.

Crescimento alométrico dos componentes da carcaça de cordeiros Texel × Ile de France confinados do desmame aos 35kg de peso vivo

Foi avaliado o crescimento alométrico de ossos, músculos e gordura, e das regiões da carcaça de cordeiros Texel × Ile de France, terminados em confinamento. Vinte cordeiros, machos não-castrados, foram desmamados aos 42 dias de idade (15,9 ± 2,1kg de peso vivo) e confinados em baias individuais recebendo alimentação ad libitum. Destes, cinco foram abatidos 10 dias após o desmame e, os remanescentes, aos 25, 30 ou 35kg de peso vivo. Para determinação do crescimento alométrico dos cortes e tecidos foi utilizada a equação exponencial Y = aXb, transformada logaritmicamente em um modelo linear. Observou-se crescimento precoce (b = 0,89) da paleta, ao passo que a perna, a costela e o pescoço apresentaram crescimento isogônico (b = 1,00, 1,03 e 1,11, respectivamente), ou seja, equivalente ao da carcaça. O aumento do peso da carcaça implicou em redução da taxa de crescimento de ossos e músculos (b = 0,60 e 0,92, respectivamente) e aumento da taxa de crescimento da gordura (b = 1,78). O crescimento muscular foi diferenciado nas distintas regiões da carcaça, sendo isogônico na paleta (b = 0,98) e na perna (b = 0,99) e precoce na costela (b = 0,90) e no pescoço (b = 0,79). Recomenda-se que o abate de cordeiros Texel × Ile de France seja realizado com, no máximo, 30kg de peso vivo.

Comparison of full-field electroretinogram in diabetic and non diabetic dogs with cataracts

Being the commonest ocular disorder, dense cataracts disable fundoscopic examination and the diagnosis of retinal disorders, which dogs may be predisposed. The aim of this study was to compare the electroretinographic responses recorded according to the International Society for Clinical Electrophysiology of Vision human protocol to evaluate retinal function of diabetic and non diabetic dogs, both presenting mature or hypermature cataracts. Full-field electroretinogram was recorded from 66 dogs, with ages varying from 6 to 15 years old allocated into two groups: (1) CG, non diabetic cataractous dogs, and (2) DG, diabetic cataractous dogs. Mean peak-to-peak amplitude (microvolts) and b-wave implicit time (milliseconds) were determined for each of the five standard full-field ERG responses (rod response, maximal response, oscillatory potentials, single-flash cone response and 30 Hz flicker). Comparing CG to DG, ERGs recorded from diabetic dogs presented lower amplitude and prolonged b-wave implicit time in all ERG responses. Prolonged b-wave implicit time was statistically significant (p< 0.05) at 30 Hz flicker (24.0 ms versus 22.4 ms). These data suggests full-field ERG is capable to record sensible alterations, such as flicker's implicit time, being useful to investigate retinal dysfunction in diabetic dogs.

KINETICS VERSUS HYDRODYNAMICS: GENERALIZATION OF LANDAU/COOPER-FRYE PRESCRIPTION FOR FREEZE-OUT

The problem of spectra formation in hydrodynamic approach to A + A collisions is considered within the Boltzmann equations. It is shown analytically and illustrated by numerical calculations that the particle momentum spectra can be presented in the Cooper-R-ye form despite freeze-out is not sharp and has the finite temporal width. The latter is equal to the inverse of the particle collision rate at points (t(sigma) (r, p), r) of the maximal emission at a fixed momentum p. The set of these points forms the hypersurfaces t(sigma)(r,p) which strongly depend on the values of p and typically do not enclose completely the initially dense matter. This is an important difference from the standard Cooper-Frye prescription (CFp), with a common freeze-out hypersurface for all p, that affects significantly the predicted spectra. Also, the well known problem of CFp as for negative contributions to the spectra from non-space-like parts of the freeze-out hypersurface is naturally eliminated in this improved prescription.

S matrix on the Moyal plane: Locality versus Lorentz invariance

Twisted quantum field theories on the Groenewold-Moyal plane are known to be nonlocal. Despite this nonlocality, it is possible to define a generalized notion of causality. We show that interacting quantum field theories that involve only couplings between matter fields, or between matter fields and minimally coupled U(1) gauge fields are causal in this sense. On the other hand, interactions between matter fields and non-Abelian gauge fields violate this generalized causality. We derive the modified Feynman rules emergent from these features. They imply that interactions of matter with non-Abelian gauge fields are not Lorentz- and CPT-invariant.

Substrate orientation effect on potential fluctuations in multiquantum wells of GaAs/AlGaAs

The photoluminescence (PL) technique as a function of temperature and excitation intensity was used to study the optical properties of multiquantum wells (MQWs) of GaAs/Al(x)Ga(1-x)As grown by molecular beam epitaxy on GaAs substrates oriented in the [100], [311]A, and [311]B directions. The asymmetry presented by the PL spectra of the MQWs with an apparent exponential tail in the lower-energy side and the unusual behavior of the PL peak energy versus temperature (blueshift) at low temperatures are explained by the exciton localization in the confinement potential fluctuations of the heterostructures. The PL peak energy dependence with temperature was fitted by the expression proposed by Passler [Phys. Status Solidi B 200, 155 (1997)] by subtracting the term sigma(2)(E)/k(B)T, which considers the presence of potential fluctuations. It can be verified from the PL line shape, the full width at half maximum of PL spectra, the sigma(E) values obtained from the adjustment of experimental points, and the blueshift maximum values that the samples grown in the [311]A/B directions have higher potential fluctuation amplitude than the sample grown in the [100] direction. This indicates a higher degree of the superficial corrugations for the MQWs grown in the [311] direction. (C) 2008 American Institute of Physics.

Modeling of functionally graded piezoelectric ultrasonic transducers

The application of functionally graded material (FGM) concept to piezoelectric transducers allows the design of composite transducers without interfaces, due to the continuous change of property values. Thus, large improvements can be achieved, as reduction of stress concentration, increasing of bonding strength, and bandwidth. This work proposes to design and to model FGM piezoelectric transducers and to compare their performance with non-FGM ones. Analytical and finite element (FE) modeling of FGM piezoelectric transducers radiating a plane pressure wave in fluid medium are developed and their results are compared. The ANSYS software is used for the FE modeling. The analytical model is based on FGM-equivalent acoustic transmission-line model, which is implemented using MATLAB software. Two cases are considered: (i) the transducer emits a pressure wave in water and it is composed of a graded piezoceramic disk, and backing and matching layers made of homogeneous materials; (ii) the transducer has no backing and matching layer; in this case, no external load is simulated. Time and frequency pressure responses are obtained through a transient analysis. The material properties are graded along thickness direction. Linear and exponential gradation functions are implemented to illustrate the influence of gradation on the transducer pressure response, electrical impedance, and resonance frequencies. (C) 2009 Elsevier B. V. All rights reserved.

Hydrolysis of acetic anhydride: Non-adiabatic calorimetric determination of kinetics and heat exchange

A simple calorimetric method to estimate both kinetics and heat transfer coefficients using temperature-versus-time data under non-adiabatic conditions is described for the reaction of hydrolysis of acetic anhydride. The methodology is applied to three simple laboratory-scale reactors in a very simple experimental setup that can be easily implemented. The quality of the experimental results was verified by comparing them with literature values and with predicted values obtained by energy balance. The comparison shows that the experimental kinetic parameters do not agree exactly with those reported in the literature, but provide a good agreement between predicted and experimental data of temperature and conversion. The differences observed between the activation energy obtained and the values reported in the literature can be ascribed to differences in anhydride-to-water ratios (anhydride concentrations). (C) 2010 Elsevier Ltd. All rights reserved.

On the use of correlated beta random variables with animal population modelling

We give reasons why demographic parameters such as survival and reproduction rates are often modelled well in stochastic population simulation using beta distributions. In practice, it is frequently expected that these parameters will be correlated, for example with survival rates for all age classes tending to be high or low in the same year. We therefore discuss a method for producing correlated beta random variables by transforming correlated normal random variables, and show how it can be applied in practice by means of a simple example. We also note how the same approach can be used to produce correlated uniform triangular, and exponential random variables. (C) 2008 Elsevier B.V. All rights reserved.

The exponentiated generalized gamma distribution with application to lifetime data

A four-parameter extension of the generalized gamma distribution capable of modelling a bathtub-shaped hazard rate function is defined and studied. The beauty and importance of this distribution lies in its ability to model monotone and non-monotone failure rate functions, which are quite common in lifetime data analysis and reliability. The new distribution has a number of well-known lifetime special sub-models, such as the exponentiated Weibull, exponentiated generalized half-normal, exponentiated gamma and generalized Rayleigh, among others. We derive two infinite sum representations for its moments. We calculate the density of the order statistics and two expansions for their moments. The method of maximum likelihood is used for estimating the model parameters and the observed information matrix is obtained. Finally, a real data set from the medical area is analysed.