Effectiveness of postoperative radiotherapy after radical cystectomy for locally advanced bladder cancer

BACKGROUND: Local-regional failure (LF) for locally advanced bladder cancer (LABC) after radical cystectomy (RC) is common even with chemotherapy and is associated with high morbidity/mortality. Postoperative radiotherapy (PORT) can reduce LF and may enhance overall survival (OS) but has no defined role. We hypothesized that the addition of PORT would improve OS in LABC in a large nationwide oncology database. METHODS: We identified ≥ pT3pN0-3M0 LABC patients in the National Cancer Database diagnosed 2004-2014 who underwent RC ± PORT. OS was calculated using Kaplan-Meier and Cox proportional hazards regression modeling was used to identify predictors of OS. Propensity matching was performed to match RC patients who received PORT vs those who did not. RESULTS: 15,124 RC patients were identified with 512 (3.3%) receiving PORT. Median OS was 20.0 months (95% CI, 18.2-21.8) for PORT vs 20.8 months (95% CI, 20.3-21.3) for no PORT (P = 0.178). In multivariable analysis, PORT was independently associated with improved OS: hazard ratio 0.87 (95% CI, 0.78-0.97); P = 0.008. A one-to-three propensity match yielded 1,858 patients (24.9% receiving PORT and 75.1% without). In the propensity-matched cohort, median OS was 19.8 months (95% CI, 18.0-21.6) for PORT vs 16.9 months (95% CI, 15.6-18.1) for no PORT (P = 0.030). In the propensity-matched cohort of urothelial carcinoma patients (N = 1,460), PORT was associated with improved OS for pT4, pN+, and positive margins (P \u3c 0.01 all). CONCLUSION: In this observational cohort, PORT was associated with improved OS in LABC. While the data should be interpreted cautiously, these results lend support to the use of PORT in selected patients with LABC, regardless of histology. Prospective trials of PORT are warranted

From planning the port/city to planning the port-city : exploring the economic interface in European port cities

In last three decades, planning agencies of most ports have institutionally evolved into a (semi-) independent port authority. The rationale behind this process is that port authorities are able to react more quickly to changing logistical and spatial preferences of maritime firms, hence increasing the competitiveness of ports. Although these dedicated port authorities have proven to be largely successful, new economic, social, and environmental challenges are quickly catching up on these port governance models, and particularly leads to (spatial) policy ‘conflicts’ between port and city. This chapter starts by assessing this conflict and argue that the conflict is partly a result of dominant—often also academic—spatial representations of the port city as two separate entities. To escape this divisive conception of contemporary port cities, this chapter presents a relational visualisation method that is able to analyse the economic interface between port and city. Based on our results, we reflect back on our proposition and argue that the core challenge today for researchers and policy makers is acknowledging the bias of port/city, being arguably a self-fulfilling prophecy. Hence, we turn the idea of (planning the) port/city conflicts into planning the port-city’s strengths and weaknesses

Input-output relations for a 3-port grating coupled Fabry-Perot cavity

We analyze an optical 3-port reflection grating by means of a scattering matrix formalism. Amplitude and phase relations between the 3 ports, i.e. the 3 orders of diffraction are derived. Such a grating can be used as an all-reflective, low-loss coupler to Fabry-Perot cavities. We derive the input output relations of a 3-port grating coupled cavity and find distinct properties not present in 2-port coupled cavities. The cavity relations further reveal that the 3-port coupler can be designed such that the additional cavity port interferes destructively. In this case the all-reflective, low-loss, single-ended Fabry-Perot cavity becomes equivalent to a standard transmissive, 2-port coupled cavity

The Historical Development of the Port of Livorno (Italy) and Its New Port Plan 2010 in Advanced Stage of Elaboration

The geographical location makes the port of Livorno one of the most important in Italy. The port, in fact, benefits of an extended network of roads and rails connecting it with the rest of Italy, and central and southern Europe as well. The history of Livorno and its port is inextricably linked to that of Pisa and Florence, and to the complexity of events that determined the political set-up of the region along several centuries. Looking at the new port plan of Livorno has made it necessary an extensive overview of the history of both the port, and of its planning. This analysis has allowed: to understand the reason for the different choices made in the past for the development of the port, highlighting, when necessary, the errors made; to identify the strengths and weaknesses of the existing port infrastructure; to identify the works needed to boost the port in the European context. The purpose of this paper is to provide a summary of the analysis performed for the implementation of the new Livorno port plan 2010 and show how the port planning in Italy is often conditioned by hundreds of centuries of history

On interconnections of infinite-dimensional port-Hamiltonian systems

Network modeling of complex physical systems leads to a class of nonlinear systems called port-Hamiltonian systems, which are defined with respect to a Dirac structure (a geometric structure which formalizes the power-conserving interconnection structure of the system). A power conserving interconnection of Dirac structures is again a Dirac structure. In this paper we study interconnection properties of mixed finite and infinite dimensional port-Hamiltonian systems and show that this interconnection again defines a port-Hamiltonian system. We also investigate which closed-loop port-Hamiltonian systems can be achieved by power conserving interconnections of finite and infinite dimensional port-Hamiltonian systems. Finally we study these results with particular reference to the transmission line

Transfer valve Patent

Three-port transfer valve with one port open continuously suitable for manned space fligh