Hypofractionated radiotherapy versus conventionally fractionated radiotherapy for patients with intermediate-risk localised prostate cancer: 2-year patient-reported outcomes of the randomised, non-inferiority, phase 3 CHHiP trial

BACKGROUND: Patient-reported outcomes (PROs) might detect more toxic effects of radiotherapy than do clinician-reported outcomes. We did a quality of life (QoL) substudy to assess PROs up to 24 months after conventionally fractionated or hypofractionated radiotherapy in the Conventional or Hypofractionated High Dose Intensity Modulated Radiotherapy in Prostate Cancer (CHHiP) trial.

METHODS: The CHHiP trial is a randomised, non-inferiority phase 3 trial done in 71 centres, of which 57 UK hospitals took part in the QoL substudy. Men with localised prostate cancer who were undergoing radiotherapy were eligible for trial entry if they had histologically confirmed T1b-T3aN0M0 prostate cancer, an estimated risk of seminal vesicle involvement less than 30%, prostate-specific antigen concentration less than 30 ng/mL, and a WHO performance status of 0 or 1. Participants were randomly assigned (1:1:1) to receive a standard fractionation schedule of 74 Gy in 37 fractions or one of two hypofractionated schedules: 60 Gy in 20 fractions or 57 Gy in 19 fractions. Randomisation was done with computer-generated permuted block sizes of six and nine, stratified by centre and National Comprehensive Cancer Network (NCCN) risk group. Treatment allocation was not masked. UCLA Prostate Cancer Index (UCLA-PCI), including Short Form (SF)-36 and Functional Assessment of Cancer Therapy-Prostate (FACT-P), or Expanded Prostate Cancer Index Composite (EPIC) and SF-12 quality-of-life questionnaires were completed at baseline, pre-radiotherapy, 10 weeks post-radiotherapy, and 6, 12, 18, and 24 months post-radiotherapy. The CHHiP trial completed accrual on June 16, 2011, and the QoL substudy was closed to further recruitment on Nov 1, 2009. Analysis was on an intention-to-treat basis. The primary endpoint of the QoL substudy was overall bowel bother and comparisons between fractionation groups were done at 24 months post-radiotherapy. The CHHiP trial is registered with ISRCTN registry, number ISRCTN97182923.

FINDINGS: 2100 participants in the CHHiP trial consented to be included in the QoL substudy: 696 assigned to the 74 Gy schedule, 698 assigned to the 60 Gy schedule, and 706 assigned to the 57 Gy schedule. Of these individuals, 1659 (79%) provided data pre-radiotherapy and 1444 (69%) provided data at 24 months after radiotherapy. Median follow-up was 50·0 months (IQR 38·4-64·2) on April 9, 2014, which was the most recent follow-up measurement of all data collected before the QoL data were analysed in September, 2014. Comparison of 74 Gy in 37 fractions, 60 Gy in 20 fractions, and 57 Gy in 19 fractions groups at 2 years showed no overall bowel bother in 269 (66%), 266 (65%), and 282 (65%) men; very small bother in 92 (22%), 91 (22%), and 93 (21%) men; small bother in 26 (6%), 28 (7%), and 38 (9%) men; moderate bother in 19 (5%), 23 (6%), and 21 (5%) men, and severe bother in four (<1%), three (<1%) and three (<1%) men respectively (74 Gy vs 60 Gy, ptrend=0.64, 74 Gy vs 57 Gy, ptrend=0·59). We saw no differences between treatment groups in change of bowel bother score from baseline or pre-radiotherapy to 24 months.

INTERPRETATION: The incidence of patient-reported bowel symptoms was low and similar between patients in the 74 Gy control group and the hypofractionated groups up to 24 months after radiotherapy. If efficacy outcomes from CHHiP show non-inferiority for hypofractionated treatments, these findings will add to the growing evidence for moderately hypofractionated radiotherapy schedules becoming the standard treatment for localised prostate cancer.

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

Chromatic Aberration

Chromatic Aberration is a film installation which explores the early technologies of colour filmmaking drawn from the archives of George Eastman House, Rochester, New York. Featuring vibrant close-ups of eyes from fledgling archival experiments in colour film, Chromatic Aberration turns the cinematic lens in on itself: from the prosthetic recording eye of the camera, to an evocation of the abstract inner screen of one's eyelids. Early 1920s colour film footage - mainly tests shots featuring members of George Eastman's family as well as Hollywood stars of the time - is shot in such a way so as to reveal the inherent chromatic fringing, distortion and misalignment. Using specialist equipment at the BFI National Archive, London, the footage is reworked through the use of extreme close-up and magnification, honing in on the eyes. The installation evokes an imagined abstract colour world, a flickering eyelid trapped in a mechanical peephole. Exhibitions: Solo exhibition as film installation at Tyneside Cinema (Newcastle, Oct-Nov 2014); Solo exhibition at George Eastman Museum (Rochester, New York, Jan-April 2015), including a second work on display. Film festivals nominations for competitions: Winner of Best Vanguard Film Competition in Lima Independiente International Film Festival (Peru). Nominations: Filmadrid festival (Spain); Curtas Vila do Conde film festival (Portugal); Festival du Nouveau Cinema (Canada); Jihlava International Documentary Film Festival (Czech Republic ); International Film Festival Bratislava (Slovenia). Additional screenings at International Rotterdam Film Festival (Netherlands); European Media Art Festival (Germany); BFI London Film Festival (UK); Mini-retrospective screening at DIM CINEMA, The Cinematheque (Vancouver May 2015). Reviews and interviews in Artforum, The Wire Magazine, After Image, Studio International. Public lectures: with Prof. Sarah Street at Tyneside Cinema (Nov 2014); Royal Academy visiting public lecture (Nov 2014); ‘The Laughter of Things’ symposium, International Film Festival Rotterdam and Piet Zwart Institute (Jan 2015); George Eastman Museum and Rochester University (April 2015). Acquired by the George Eastman Museum for their collection.

The role of implicit theories in the formation of expert opinion in portuguese criminal law

Tese de doutoramento, Ciências e Tecnologias da Saúde (Medicina Legal e Ciências Forenses), Universidade de Lisboa, Faculdade de Medicina, 2014

On the performance of a blind source separation based I/Q-corrector

I and Q Channel phase and gain mismatches are of great concern in communications receiver design. In this paper we carry out a detailed performance analysis of the Blind-Source Seperation (BSS) based imbalance compensation structure. The results indicate that the BSS structure can offer adequate performance for most communication systems. Since the compensation is carried out before any modulation specific processing, the proposed compensation method works with all standard modulation formats.

Liberalization of Labor Relations in Germany and the United States: A firm-centered comparison of cross-national labor organizing at Amazon and Volkswagen

Thesis (Master's)--University of Washington, 2015

Technology transfer in Britain: the case of monoclonal antibodies

In 1975 two Cambridge scientists published a short article in Nature which announced the discovery of monoclonal antibodies. The article concluded ‘Such cultures could be valuable for medical and industrial use’. The interest which developed by the end of the decade in the industrial and financial possibilities of the new prospects opening up in biotechnology was to throw the apparent ‘failure’ to follow‐up the potentialities of this discovery into a public prominence rarely achieved by scientific discoveries. By the time Mrs Thatcher came to power it had become a scandal, another example of Britain's apparent inability to exploit effectively the brilliance of its scientific base. It was to explore both the process of scientific discovery and the conditions in Cambridge which nurtured it, and the issues which this particular discovery raised in the area of technology transfer (and the changes of policy that ensued), that the Wellcome Trust's History of Twentieth Century Medicine Group and the Institute of Contemporary British History organised this special witness seminar. It was held at the Wellcome Trust in London on 24 September 1993. The seminar was chaired by Sir Christopher Booth and introduced by Dr Robert Bud of the Science Museum. Those participating included the two authors of the Nature article, Dr César Milstein and Dr Georges Köhler, who received a Nobel Prize for their research, Dr Basil Bard (National Research Development Corporation [NRDC] 1950–74), Sir James Gowans (Secretary of the Medical Research Council [MRC] 1977–87), Sir John Gray (Secretary of the MRC 1968–77), John Newell (BBC World Service science correspondent 1969–79), Dr David Owen (MRC), and Dr David Secher (Laboratory of Molecular Biology [LMB], Cambridge). There were also contributions from Dr Ita Askonas (former head of immunology at the National Institute for Medical Research), Dr John Galloway (former member of MRC headquarters staff), Dr David Tyrrell (former Director, MRC Common Cold Unit), Professor Miles Weatherall (head of Therapeutic Research Division, Wellcome Research Laboratories 1967–75), Dr Guil Winchester (post‐doctoral fellow, Wellcome Institute for the History of Medicine), and Dr Peter Williams (former Director of the Wellcome Trust). The organisers would like to thank the Wellcome Trust for hosting and sponsoring the seminar. We would like to dedicate this publication to the memory of Georges Köhler, who sadly died in April 1995 before this could appear.

The river solofrana bicycle network: a project of green mobility

The article presents the “LungoSolofrana” project, carried out during the course “Urban and Mobility” in the academic year 2009/2010, held during the bachelor in Environmental Engineering at the University of Naples “Federico II”. The work has also been chosen as a finalist at the “UrbanPromo 2010” contest, the urban and territorial marketing event sponsored by the National Institute of Urban Planning and Urbit which was held in Venice in 2010. The project consists in a green mobility proposal, developed with an approach based on the integration of the environmental redevelopment of a portion of river Solofrana, located in the Salerno Province, and of the renewal of seven local stations of the railway line Mercato San Severino – Nocera Inferiore, including the realization of a cycle-path network for the natural environment fruition. Furthermore the work drew attention to the local and regional administration. The main intent of the project is to integrate sustainable mobility themes with the environment recovery in a territory affected by high environmental troubles. The area includes the municipalities of Nocera Inferiore, Nocera Superiore, Mercato San Severino, Castel San Giorgio and Roccapiemonte, situated in Salerno’s province, with a total population about 114.000 (font Demo ISTAT 2010). The area extension is about 84,30 sqkm and it is crossed by river Solofrana that is the central point of the project idea. The intervention strategy is defined in two kinds of actions: internal and external rail station interventions. The external rail station interventions regard the construction of pedestrian-cycle paths with the scope of increasing the spaces dedicated to cyclists and to pedestrians along the river Solofrana sides and to connect the urban areas with the railway station. In this way, it’s also possible to achieve an urban requalification of the interested area. On the other side, the interventions inside the station , according to Transit Oriented Development principles, aim at redeveloping common spaces with the insertion of new activities and at realizing new automatic cycle parks covered by photovoltaic panels. The project proposal consists of the urban regeneration of small railway stations along the route-Nocera-Codola Mercato San Severino in the province of Salerno, through interventions aimed at improving pedestrian accessibility. The project involves in particular the construction of pedestrian paths protected access to the station and connecting with neighboring towns and installation of innovative bike parking stations in elevation, covering surfaces coated with solar panels and spaces information. The project is aimed to propose a new model of sustainable transport for small and medium shifts as an alternative to private transportation

Exploration of implicit theories in the formation of expert opinion in portuguese criminal law

This dissertation examines different aspects involved in the formation of psychologists’ expert opinion in the Portuguese criminal justice system, more precisely, as this opinion is reflected in assessment reports. The present dissertation is comprised of three qualitative studies, the first sought to provide a general portrait of a sample of 106 forensic psychological reports as to their overall quality as measured in terms of relevance and coherence. Results show that the formal markers of quality are present in the sample analysed, a certain number of weaknesses have been observed, notably concerning the internal coherence of the reports as well as the relevance of the information reported on. The second study explored the opinions of 17 Portuguese judges and state prosecutors concerning the use they make of this type of forensic report. It appears that they consider these reports to be useful and very credible, specially so when they have been produced under the auspices of the National Institute of Legal Medicine and Forensic Sciences, which is the state forensic institution. Furthermore, it appears that judges and prosecutors were particularly interested in data that allowed for a personalised portrait of the assessee. The third study sought to better comprehend the conceptual bases on which psychologists construct their reports. To this end, an exploratory study was undertaken with a sample of key-actors; the analysis of their interviews shows that they define their judicial mandate as well as the basic concepts that are associated to this mandate in different ways. A theoretical framework provided by an implicit theories model was used to help understand these results.

La gestion du cadre bâti dans l'Arrondissement historique et naturel du Mont-Royal

Lorsqu’un site ou un bien est protégé par un statut patrimonial, tant national que local, les règlements d’urbanisme sont un des principaux outils d’encadrement des modifications de l’environnement bâti. Comment ces règlements participent-ils à la conservation des valeurs patrimoniales ? Pour explorer cette question, nous avons choisi le cas de l’arrondissement historique et naturel du Mont-Royal (AHNMR, renommé en 2012 site patrimonial du Mont-Royal), un site majeur pour l’identité de Montréal. Nous avons recensé les valeurs patrimoniales attribuées au site et analysé le processus de gestion des projets dans les quatre arrondissements qui se répartissent la partie montréalaise du territoire de l’AHNMR; nous avons également analysé quelques demandes de permis. Le processus est complexe, d’autant plus que l’évaluation est en bonne partie discrétionnaire, incluant des analyses de fonctionnaires et de comités consultatifs de même que des exercices de consultation publique. La recherche a permis de mettre en lumière que les règlements d’urbanisme ont tendance à se concentrer sur les valeurs dont la matérialité est connue (valeurs architecturales et paysagères notamment) et à délaisser les valeurs immatérielles (valeurs d’usage, valeurs identitaires et emblématiques). La juxtaposition des valeurs peut atténuer ce déséquilibre en protégeant une valeur immatérielle par l’entremise d’une valeur matérielle. La documentation des valeurs patrimoniales et de leur incarnation dans l’aménagement d’un site revêt une importance majeure pour l’application des critères d’évaluation. De plus, l’évaluation discrétionnaire apporte de multiple points de vue sur un projet, des opinions d’acteurs, experts en patrimoine ou non, généralement absents de l’évaluation des projets, ce qui contribue à l’évolution de ces derniers. Les consultations publiques donnent lieu à la réévaluation des valeurs patrimoniales ainsi qu’à l’approfondissement des connaissances.

Geochemistry of Rare Erath Elements and Trace Metals along the Western Continental Shelf of India

Rare earth elements have occupied an important role in marine geochemical research, particularly as used in the format of REE abundance patterns to describe the geochemical pathways in marine sedimentation and authigenesis. This study concentrates on the distribution pattern of Rare earth elements in the sediments, behavior of Eu and Ce with respect to their occurrence in multiple oxidation states. It also concentrate the depth wise variation of sediment REEs from near shore areas (30m) to deeper depths 200m) in the Arabian Sea. It includes the downcore variation of REEs and other trace elements in the sediment cores and a comparison between the REE distributions of Arabian Sea sediment with the sediments of Andaman Sea. The study gives a general introduction regarding the importance of RRE studies, its occurrence and abundance, electronic configuration, lanthanide contraction, oxidations states and REE supply to the ocean, seawater and sediments.

Chemical Oceanographic Studies of the Coastal Waters of Cochin

The present study is an attempt to understand some of the chemical oceanographic processes of the coastal water and the backwaters of Cochin. The importance of this study lies in the fact that there has been an increasing concern on the environmental degradation of Cochin backwaters with respect to water and sediments due to various anthropogenic activities. The study comprises the results and discussion of the hydro chemical parameters of coastal waters of Cochin during different seasons with statistical analysis. The parameters dealt with are salinity, temperature, pH, dissolved oxygen, nitrite-N, nitrate-N, ammonia-N, Silicate-Si, phosphate-P, chlorophyll ‘a’ and suspended solids, dissolved trace metals and sediment characteristics including sediment metals

Distribution of Benthic In fauna in the Cochin Backwaters In Relation To Environmental Parameters

The study revealed stress and localized impact of industrial waste on the biota, predominance of stress tolerant species and low diversity in the vicinity of the effluent discharge point. These studies on impact of environmental parameters on the distribution of macrobenthos thus indicate the quantum of endurance warranted by the infauna to tide over the wide range of environmental stress. Low diversity and lower number of benthic fauna near discharge site can be attributed to the stress caused by cumulative toxic effects of effluents. The results of the physico-chemical parameters highlight the effects of pollution. The results of the study indicated the changes due to the large-scale movements of the estuarine water under the influence of tide, monsoon and land runoff coupled with its heterogenous nature owing to the effluent discharge from the industries

Dynamics of Infaunal Benthic Community of the Contenental Shelf of North-Eastern Arabian Sea

In this study dynamics of infaunal benthic community of the continental shelf of north-eastern Arabian sea. The benthic (under water sea) organisms play an important role in the marine food chain. It can be concluded that seasonal differences in the benthic community was observed in lower depths and absent in deeper depths. Increased richness and diversity during pre-monsoon may be related to the increased primary production which inturn influenced by the increased nutrient input due to winter convection. No single ecological factor could be considered as a master factor. In general the area supports moderately high benthic production and diversified community.

Nutrient Dynamics in the EEZ of the West Coast of India with Special Reference to the Oxygen Minimum Zone and Denitrification

The present work aims at deciphering the processes that control the nutrient distribution along the EEZ (Exclusive Economic Zone of India) of the west coast of India and to bring out its linkage with primary and secondary productivity. This work assume utmost importance as very few studies have hitherto focused entirely on the EEZ of the west coast of India to address the biochemical responses brought about by monsoons. The present study examines the seasonal variations in physicochemical parameters and associated primary biological responses along the west coast of India. This study targets to measure and understand the shelf ocean exchange in a typical coastal upwelling region of the southeast Arabian Sea, and the influence of convective mixing along the northern part of the west coast of India. The study focuses more directly on coastal upwelling along the southwest coast of India, within the EEZ. The effects of coastal upwelling, eddy formation and the offshore advection are apparent in the present investigation. This has consequences to fisheries and climate, in energy transfer to the food chain and the increased sequestering of carbon in the ocean. The study also focuses on the Oxygen Minimum Zone (OMZ) and dentrification observed along the EEZ of the west coast of India on a seasonal scale. In the study, an attempt is also made to demarcate the geographical boundaries of the denitrification zone in the EEZ of India and on the nature and magnitude of these variations, on a seasonal and inter annual scales