Short-Course External Beam Radiotherapy Versus Brachytherapy for Palliation of Dysphagia in Esophageal Cancer: A Matched Comparison of Two Prospective Trials

Introduction: Short-course external beam radiotherapy (EBRT) and intraluminal brachytherapy are both accepted treatments for the palliation of dysphagia in patients with incurable esophageal cancer. We compared the effects of both treatments from two prospective studies. Methods: We performed a multicenter prospective cohort study of patients with metastasized or otherwise incurable esophageal cancer requiring palliation of dysphagia from September 2016 to March 2019. Patients were treated with EBRT in five fractions of 4 Gy. Data were compared with all patients treated with a single brachytherapy dose of 12 Gy in the SIREC (Stent or Intraluminal Radiotherapy for inoperable Esophageal Cancer) trial, both between the original cohorts and between 1:1 propensity score–matched cohorts. The primary end point was an improvement of dysphagia at 3 months without reintervention. The secondary end points included toxicit

Electron correlation effects in a wide channel from the ν=1\nu =1 quantum Hall edge states

The spatial behavior of Landau levels (LLs) for the $nu=1$ quantum Hall regime at the edge of a wide channel is studied in a self-consistent way by using a generalized local density approximation proposed here. Both exchange interaction and strong electron correlations, due to edge states, are taken into account. They essentially modify the spatial behavior of the occupied lowest spin-up LL in comparison with that of the lowest spin-down LL, which is totally empty. The contrast in the spatial behavior can be attributed to a different effective one-electron lateral confining potentials for the spin-split LLs. Many-body effects on the spatially inhomogeneous spin-splitting are calculated within the screened Hartree-Fock approximation. It is shown that, far from the edges, the maximum activation energy is dominated by the gap between the Fermi level and the bottom of the spin-down LL, because the gap between the Fermi level and the spin-up LL is much larger. In other words, the maximum activation energy in the bulk of the channel corresponds to a highly asymmetric position of the Fermi level within the gap between spin-down and spin-up LLs in the bulk. We have also studied the renormalization of the edge-state group velocity due to electron correlations. The results of the present theory are in line with those suggested and reported by experiments on high quality samples.Comment: 9 pages, 4 figure

Ghrelin drives GH secretion during fasting in man

OBJECTIVES: In humans, fasting leads to elevated serum GH concentrations. Traditionally, changes in hypothalamic GH-releasing hormone and somatostatin release are considered as the main mechanisms that induce this elevated GH secretion during fasting. Ghrelin is an endogenous ligand of the GH secretagogue receptor and is synthesized in the stomach. As ghrelin administration in man stimulates GH release, while serum ghrelin concentrations are elevated during fasting in man, this increase in ghrelin levels might be another mechanism whereby fasting results in stimulation of GH release. DESIGN AND SUBJECTS: In ten healthy non-obese males we performed a double-blind placebo-controlled crossover study comparing fasting with and fasting without GH receptor blockade. GH, ghrelin, insulin, glucose and free fatty acids were assessed. RESULTS: While ghrelin levels do not vary considerably in the fed state, fasting rapidly induced a diurnal rhythm in ghrelin concentrations. These changes in serum ghrelin concentrations during fasting were followed by similar, profound changes in serum GH levels. The rapid development of a diurnal ghrelin rhythm could not be explained by changes in insulin, glucos

Collective discussion ferocious architecture: Sovereign spaces/places by design

The authors in this collective discussion engage, disaggregate and unpack the triangulation of security, technology and architecture, across a range of contemporary spaces/places. Reflecting diverse interdisciplinary commitments and perspectives, the collective discussion considers security, technology and architecture in urban environments and global/local interfaces, borders, borderlands and ports of entry, and even the sensorium, from soundscapes of the airport to teargas laden environments. From quotidian to high-tech, these interventions tease out the increasing ferocity of architecture and/in its relationship with technology and security. © The Authors 2016

Long-term male fertility after treatment with radioactive iodine for differentiated thyroid carcinoma

Context: Whilst radioactive iodine (RAI) is often administered in the treatment for differentiated thyroid carcinoma (DTC), long-term data on male fertility after RAI are scarce. Objective: To evaluate long-term male fertility after RAI for DTC, and to compare semen quality before and after RAI. Design, setting, and patients: Multicenter study including males with DTC ≥2 years after their final RAI treatment with a cumulative activity of ≥3.7 GBq. Main outcome measure(s): Semen analysis, hormonal evaluation, and a fertility-focused questionnaire. Cut-off scores for 'low semen quality' were based on reference values of the general population as defined by the World Health Organization (WHO). Results: Fifty-one participants had a median age of 40.5 (interquartile range (IQR): 34.0-49.6) years upon evaluation and a median follow-up of 5.8 (IQR: 3.0-9.5) years after their last RAI administration. The median cumulative administered activity of RAI was 7.4 (range: 3.7-23.3) GBq. The proportion of males with a low semen volume, concentration, progressive motility, or total motile sperm count did not differ from the 10th percentile cut-off of a general population (P = 0.500, P = 0.131, P = 0.094, and P = 0.500, respectively). Cryopreserved semen was used by 1 participant of the 20 who had preserved semen. Conclusions: Participants had a normal long-term semen quality. The proportion of participants with low semen quality parameters scoring below the 10th percentile did not differ from the general population. Cryopreservation of semen of males with DTC is not crucial for conceiving a child after RAI administration but may be considered in individual cases

Architecture and performance of the KM3NeT front-end firmware

The KM3NeT infrastructure consists of two deep-sea neutrino telescopes being deployed in the Mediterranean Sea. The telescopes will detect extraterrestrial and atmospheric neutrinos by means of the incident photons induced by the passage of relativistic charged particles through the seawater as a consequence of a neutrino interaction. The telescopes are configured in a three-dimensional grid of digital optical modules, each hosting 31 photomultipliers. The photomultiplier signals produced by the incident Cherenkov photons are converted into digital information consisting of the integrated pulse duration and the time at which it surpasses a chosen threshold. The digitization is done by means of time to digital converters (TDCs) embedded in the field programmable gate array of the central logic board. Subsequently, a state machine formats the acquired data for its transmission to shore. We present the architecture and performance of the front-end firmware consisting of the TDCs and the state machine

In vitro evaluation of the performance of Granada selective enrichment broth for the detection of group B streptococcal colonization

A broth for the screening of group B streptococcal (GBS) carriage during pregnancy is about to be introduced. Simulating conditions in everyday practice, we have compared the sensitivity of this Granada tube broth (GT) with that of classical Amies transport medium (AT) in vitro. A total of 1,485 GT and 1,485 AT were tested with 33 well-characterized GBS strains in three different concentrations, five different incubation times, and three different temperatures. After initial incubation at room temperature (RT) or 4°C, GT were placed at 37°C. GT were scored for the presence of orange pigment. GT and AT were subcultured on blood agar (BA). Pigment was observed in 98% of GT incubated at 37°C. GBS could be cultured in 91%, 73%, and 55% of GT incubated at 37°C, RT, or 4°C, respectively. For AT, these percentages were only 20% at 37°C, 52% at RT, and 59% at 4°C. When GT initially incubated at RT or 4°C were subsequently incubated at 37°C, the sensitivity improved significantly. We conclude that GT is a more sensitive GBS transport and culture medium than the conventional method, especially for low inocula and prolonged transport/incubation times. GT does not exclude the presence of GBS, and should always be incubated at 37°C and subcultured on solid agar for optimal sensitivity

Energy Loss of Gluons, Baryons and k-Quarks in an N=4 SYM Plasma

We consider different types of external color sources that move through a strongly-coupled thermal N=4 super-Yang-Mills plasma, and calculate, via the AdS/CFT correspondence, the dissipative force (or equivalently, the rate of energy loss) they experience. A bound state of k quarks in the totally antisymmetric representation is found to feel a force with a nontrivial k-dependence. Our result for k=1 (or k=N-1) agrees at large N with the one obtained recently by Herzog et al. and Gubser, but contains in addition an infinite series of 1/N corrections. The baryon (k=N) is seen to experience no drag. Finally, a heavy gluon is found to be subject to a force which at large N is twice as large as the one experienced by a heavy quark, in accordance with gauge theory expectations.Comment: Latex 2e, 24 pages, 1 eps figure; v2: slightly amplified discussion on the relation between the drag force and the tension of a spatial Wilson loop; v3: minor changes, version to appear in JHE

Real-time nonequilibrium dynamics in hot QED plasmas: dynamical renormalization group approach

We study the real-time nonequilibrium dynamics in hot QED plasmas implementing a dynamical renormalization group and using the hard thermal loop (HTL) approximation. The focus is on the study of the relaxation of gauge and fermionic mean fields and on the quantum kinetics of the photon and fermion distribution functions. For semihard photons of momentum eT << k << T we find to leading order in the HTL that the gauge mean field relaxes in time with a power law as a result of infrared enhancement of the spectral density near the Landau damping threshold. The dynamical renormalization group reveals the emergence of detailed balance for microscopic time scales larger than 1/k while the rates are still varying with time. The quantum kinetic equation for the photon distribution function allows us to study photon production from a thermalized quark-gluon plasma (QGP) by off-shell effects. We find that for a QGP at temperature T ~ 200 MeV and of lifetime 10 < t < 50 fm/c the hard (k ~ T) photon production from off-shell bremsstrahlung (q -> q \gamma and \bar{q} -> \bar{q}\gamma) at O(\alpha) grows logarithmically in time and is comparable to that produced from on-shell Compton scattering and pair annihilation at O(\alpha \alpha_s). Fermion mean fields relax as e^{-\alpha T t ln(\omega_P t)} with \omega_P=eT/3 the plasma frequency, as a consequence of the emission and absorption of soft magnetic photons. A quantum kinetic equation for hard fermions is obtained directly in real time from a field theoretical approach improved by the dynamical renormalization group. The collision kernel is time-dependent and infrared finite.Comment: RevTeX, 46 pages, including 5 EPS figures, published versio

Anomalous Pseudoscalar-Photon Vertex In and Out of Equilibrium

The anomalous pseudoscalar-photon vertex is studied in real time in and out of equilibrium in a constituent quark model. The goal is to understand the in-medium modifications of this vertex, exploring the possibility of enhanced isospin breaking by electromagnetic effects as well as the formation of neutral pion condensates in a rapid chiral phase transition in peripheral, ultrarelativistic heavy-ion collisions. In equilibrium the effective vertex is afflicted by infrared and collinear singularities that require hard thermal loop (HTL) and width corrections of the quark propagator. The resummed effective equilibrium vertex vanishes near the chiral transition in the chiral limit. In a strongly out of equilibrium chiral phase transition we find that the chiral condensate drastically modifies the quark propagators and the effective vertex. The ensuing dynamics for the neutral pion results in a potential enhancement of isospin breaking and the formation of $\pi^0$ condensates. While the anomaly equation and the axial Ward identity are not modified by the medium in or out of equilibrium, the effective real-time pseudoscalar-photon vertex is sensitive to low energy physics.Comment: Revised version to appear in Phys. Rev. D. 42 pages, 4 figures, uses Revte