Induction chemotherapy followed by chemoradiotherapy versus chemoradiotherapy alone as neoadjuvant treatment for locally recurrent rectal cancer: study protocol of a multicentre, open-label, parallel-arms, randomized controlled study (PelvEx II)

Background A resection with clear margins (R0 resection) is the most important prognostic factor in patients with locally recurrent rectal cancer (LRRC). However, this is achieved in only 60 per cent of patients. The aim of this study is to investigate whether the addition of induction chemotherapy to neoadjuvant chemo(re)irradiation improves the R0 resection rate in LRRC. Methods This multicentre, international, open-label, phase III, parallel-arms study will enrol 364 patients with resectable LRRC after previous partial or total mesorectal resection without synchronous distant metastases or recent chemo- and/or radiotherapy treatment. Patients will be randomized to receive either induction chemotherapy (three 3-week cycles of CAPOX (capecitabine, oxaliplatin), four 2-week cycles of FOLFOX (5-fluorouracil, leucovorin, oxaliplatin) or FOLFORI (5-fluorouracil, leucovorin, irinotecan)) followed by neoadjuvant chemoradiotherapy and surgery (experimental arm) or neoadjuvant chemoradiotherapy and surgery alone (control arm). Tumours will be restaged using MRI and, in the experimental arm, a further cycle of CAPOX or two cycles of FOLFOX/FOLFIRI will be administered before chemoradiotherapy in case of stable or responsive disease. The radiotherapy dose will be 25 × 2.0 Gy or 28 × 1.8 Gy in radiotherapy-naive patients, and 15 × 2.0 Gy in previously irradiated patients. The concomitant chemotherapy agent will be capecitabine administered twice daily at a dose of 825 mg/m2 on radiotherapy days. The primary endpoint of the study is the R0 resection rate. Secondary endpoints are long-term oncological outcomes, radiological and pathological response, toxicity, postoperative complications, costs, and quality of life. Discussion This trial protocol describes the PelvEx II study. PelvEx II, designed as a multicentre, open-label, phase III, parallel-arms study, is the first randomized study to compare induction chemotherapy followed by neoadjuvant chemo(re)irradiation and surgery with neoadjuvant chemo(re)irradiation and surgery alone in patients with locally recurrent rectal cancer, with the aim of improving the number of R0 resections

The Single-Phase ProtoDUNE Technical Design Report

ProtoDUNE-SP is the single-phase DUNE Far Detector prototype that is under construction and will be operated at the CERN Neutrino Platform (NP) starting in 2018. ProtoDUNE-SP, a crucial part of the DUNE effort towards the construction of the first DUNE 10-kt fiducial mass far detector module (17 kt total LAr mass), is a significant experiment in its own right. With a total liquid argon (LAr) mass of 0.77 kt, it represents the largest monolithic single-phase LArTPC detector to be built to date. It's technical design is given in this report

Emotional sweating across the body: Comparing 16 different skin conductance measurement locations

Skin conductance (SC) is one of the most commonly used measures in psychophysiological studies involving emotional arousal and is traditionally measured at the fingers or the palms (i.e., the palmar locations) of the hand. Palmar skin conductance recording positions are, however, not always preferred for ambulatory recordings in real-life situations. This study quantifies the responsiveness and similarity with the finger of 16 different recording positions of skin conductance while watching emotional film fragments. Findings indicated foot, fingers and shoulders being most responsive, whereas arm, back, armpit, and thighbone were least responsive. The measurements at the foot were most similar with those of the finger. In contrast, arm, back, and armpit traces differed most from the finger trace. Taken together, foot and shoulders are the best alternatives to the finger for ambulatory measurement of skin conductance to reflect emotional arousal. These findings can help new applications using skin conductance, like automated emotion measurements, to come to fruition

Towards unobtrusive automated sleep stage classification:polysomnography using electrodes on the face

\u3cp\u3eAlthough sleep stage annotation (SSA) is historically known from clinical practice and typically performed by a certified expert on the basis of visual examination of polysomnography (PSG) signals. Automatic SSA has emerged as a tool to assist sleep experts and to accelerate the analysis of PSG data. New advances in signal processing and sensor technology start to enable the application of SSA in home solutions as well. In today's busy lives, sleep plays a central role and good quality sleep helps us to deal with the stress of everyday life. Being able to enhance sleep quality thus is a major opportunity to help people in reducing the influence of stress on their live, health and wellbeing. The advent of consumer products aimed at enhancing the sleep experience has propelled the need for home sleep monitoring and inducing solutions which can i) provide automatic SSA using sensors that interfere minimally with the sleep process and ii) provide sleep stage information in real-time in order to be suitable for closed-loop sleep inducing solutions. In this paper, we examine two possible alternatives for unobtrusive sleep monitoring. The first one uses respiratory, cardiac and wrist actigraphy signals while the second one relies on Facial PSG electrodes positioned on the facial area which allow for unobtrusive and comfortable sensors arrangements.\u3c/p\u3

Towards process mining of EMR data:case study for sepsis management

\u3cp\u3eImagine you have cold shivers and a racing heartbeat and high fever. Clear thinking is impossible! Ceiling lights flash by as you are rushed to the emergency department (ED). You feel your body is getting even sicker. Doctors are doing their utmost to treat this acute and threatening condition, while they work piece together all small parts of evidence to set the diagnosis and start targeted treatment. In this situation, the clinical staff depends on a clinical pathway protocol to streamline communication and deliver care according to the latest medical evidence. Today, such clinical pathways are mainly executed and tracked using paper. Hence, there is ample opportunity for technology in a supportive role. Automated process analysis can help improve these processes of delivering standardized care beyond their current level. In this paper, we provide insight into the steps required to perform process mining to EMR data in the challenging domain of sepsis treatment and provide learnings from our preliminary analysis of these data using process mining techniques.\u3c/p\u3

How to stay in the emotional rollercoaster:lessons learnt from designing EmRoll

\u3cp\u3eBodily expressions can be used to involve players in intense experiences with games. By physically moving, breathing, or increasing your pulse, you may start emotional processes that help create for a stronger experience of the narrative in the game. We have designed a system named EmRoll that poses riddles to pairs of players. The riddles can only be solved if the players are, or at least pretend to be, moving according to different emotional states: dancing happily, relaxed breathing and being scared. The system measures movement, breathing and sweat reactions from the two pl ayer s. Lessons learnt were: playing in pairs is an important aspect as the two players influenced one-another, pulling each other into stronger experiences; getting excited through intense movement when involving your whole body worked well, as did relaxing through deep breathing; using the sweat response as an input mechanism worked less well; and finally, putting a Wizard (a human operator) into the loop can help bootstrap difficulty balancing and thereby increase emotional involvement.\u3c/p\u3