Is moderate hypofractionation accepted as a new standard of care in north america for prostate cancer patients treated with external beam radiotherapy? Survey of genitourinary expert radiation oncologists

INTRODUCTION: Several recent randomized clinical trials have evaluated hypofractionated regimens against conventionally fractionated EBRT and shown similar effectiveness with conflicting toxicity results. The current view regarding hypofractionation compared to conventional EBRT among North American genitourinary experts for management of prostate cancer has not been investigated. MATERIALS AND METHODS: A survey was distributed to 88 practicing North American GU physicians serving on decision - making committees of cooperative group research organizations. Questions pertained to opinions regarding the default EBRT dose and fractionation for a hypothetical example of a favorable intermediate - risk prostate cancer (Gleason 3 + 4). Treatment recommendations were correlated with practice patterns using Fisher's exact test. RESULTS: Forty - two respondents (48%) completed the survey. We excluded from analysis two respondents who selected radical hypofractionation with 5 - 12 fractions as a preferred treatment modality. Among the 40 analyzed respondents, 23 (57.5%) recommend conventional fractionation and 17 (42.5%) recommended moderate hypofractionation. No demographic factors were found to be associated with preference for a fractionation regimen. Support for brachytherapy as a first choice treatment modality for low - risk prostate cancer was borderline significantly associated with support for moderate hypofractionated EBRT treatment modality (p = 0.089). CONCLUSIONS: There is an almost equal split among North American GU expert radiation oncologists regarding the appropriateness to consider moderately hypofractionated EBRT as a new standard of care in management of patients with prostate cancer. Physicians who embrace brachytherapy may be more inclined to support moderate hypofractionated regimen for EBRT. It is unclear whether reports with longer followups will impact this balance, or whether national care and reimbursement policies will drive the clinical decisions. In the day and age of patient - centered care delivery, patients should receive an objective recommendation based on available clinical evidence. The stark division among GU experts may influence the design of future clinical trials utilizing EBRT for patients with prostate cancer

Characterization of Acetogenic and Methanogenic Leachates Generated from a Sanitary Landfill Site

Decomposition processes take place in landfill generate leachates that can be categorized mainly of acetogenic and methanogenic in nature. BOD:COD ratio computed in this study for a landfill site over a 3 years duration revealed as a good indicator to identify acetogenic leachate from methanogenic leachate. Correlation relationships to predict pollutant level taking into consideration of climatic condition are derived

Study Of Carbonaceous And Nitrogenous Pollutants In Leachate Of A Sanitary Landfill Site

The characteristics of leachate from a mature landfill site were investigated over a period of six years to provide useful information for the design and management of landfill leachate. Data analysis revealed that low carbonaceous and nitrogenous pollutants can be achieved with proper groundwater and surface water management and also recirculation of leachate to control stabilization of decomposition in the waste layers

Decoding Subjective Intensity of Nociceptive Pain from Pre-stimulus and Post-stimulus Brain Activities

Pain is a highly subjective experience. Self-report is the gold standard for pain assessment in clinical practice, but it may not be available or reliable in some populations. Neuroimaging data, such as electroencephalography (EEG) and functional magnetic resonance imaging (fMRI), have the potential to be used to provide physiology-based and quantitative nociceptive pain assessment tools that complements self-report. However, existing neuroimaging-based nociceptive pain assessments only rely on the information in pain-evoked brain activities, but neglect the fact that the perceived intensity of pain is also encoded by ongoing brain activities prior to painful stimulation. Here, we proposed to use machine learning algorithms to decode pain intensity from both pre-stimulus ongoing and post-stimulus evoked brain activities. Neural features that were correlated with intensity of laser-evoked nociceptive pain were extracted from high-dimensional pre- and post-stimulus EEG and fMRI activities using partial least-squares regression (PLSR). Further, we used support vector machine (SVM) to predict the intensity of pain from pain-related time-frequency EEG patterns and BOLD-fMRI patterns. Results showed that combining predictive information in pre- and post-stimulus brain activities can achieve significantly better performance in classifying high-pain and low-pain and in predicting the rating of perceived pain than only using post-stimulus brain activities. Therefore, the proposed pain prediction method holds great potential in basic research and clinical applications.published_or_final_versio

Rare K decays in a model of quark and lepton masses

An extension of a model of neutrino masses to the quark sector provides an interesting link between these two sectors. A parameter which is important to describe neutrino oscillations and masses is found to be a crucial one appearing in various ``penguin'' operators, in particular the so-called Z penguin. This parameter is severely constrained by the rare decay process $K_{L} \to \mu^{+} \mu^{-}$. This in turn has interesting implications on the decay rates of other rare processes such as $K_{L} \to \mu e$, etc..., as well as on the masses of the neutrinos and the masses of the vector-like quarks and leptons which appear in our model.Comment: 34 pages, 10 figures, corrected some typos in the introductio

Dynamic Programming Approach to Image Segmentation and its Application to Pre-processing of Mammograms

Images egmentationis an importent componento f imagop rocessings irce significantt ime can be savedi f a region of interest is extracted by al efficient segmentationa lgorithm. A dynamic programming image segmentation algorithnr is presented. The algorithm is applicable to images with a large matrix of gray levels of pixel values and generatesa path separatingt he object from the background.T he report of a.na pplication of the proposed algorithm to digitised mammotramsc omplementsit s description

Kaluza-Klein Structure Associated With Fat Brane

It is known that the imposition of orbifold boundary conditions on background scalar field can give rise to a non-trivial vacuum expectation value (VEV) along extra dimensions, which in turn generates fat branes and associated unconventional Kaluza-Klein (KK) towers of fermions. We study the structure of these KK towers in the limit of one large extra dimension and show that normalizable (bound) states of massless and massive fermions can exist at both orbifold fixed points. Closer look however indicates that orbifold boundary conditions act to suppress at least half of bound KK modes, while periodic boundary conditions tend to drive the high-lying modes to the conventional structure. By investigating the scattering of fermions on branes, we analytically compute masses and wavefunctions of KK spectra in the presence of these boundary conditions up to one-loop level. Implication of KK-number non-conservation couplings on the Coulomb potential is also examined.Comment: RevTex4, 29 pages, 7 ps figures, new references adde