Merkel cell carcinoma of skin-current controversies and recommendations

The review covers the current recommendations for Merkel cell carcinoma (MCC), with detailed discussion of many controversies. The 2010 AJCC staging system is more in-line with other skin malignancies although more complicated to use. The changes in staging system over time make comparison of studies difficult. A wide excision with margins of 2.5–3 cm is generally recommended. Even for primary </= 1 cm, there is a significant risk of nodal and distant metastases and hence sentinel node biopsy should be done if possible; otherwise adjuvant radiotherapy to the primary and nodal region should be given. Difficulties of setting up trials owing to the rarity of the disease and the mean age of the patient population result in infrequent reports of adjuvant or concurrent chemotherapy in the literature. The benefit, if any, is not great from published studies so far. However, there may be a subgroup of patients with high-risk features, e.g. node-positive and excellent performance status, for whom adjuvant or concurrent chemotherapy may be considered. Since local recurrence and metastases generally occur within 2 years of the initial diagnosis, patients should be followed more frequently in the first 2 years. However delayed recurrence can still occur in a small proportion of patients and long-term follow-up by a specialist is recommended provided that the general condition of the patient allows it. In summary, physician judgment in individual cases of MCC is advisable, to balance the risk of recurrence versus the complications of treatment

Dose investigation of the mamosite applicator using monte carlo method

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Tree based routing protocol in WSNs: A comparative performance study of the routing protocols DEEC and RPL Riyadh, Kingdom of Saudi Arabi

Abstract Recently, energy optimization i

Toward Realization of 2.4 GHz Balunless Narrowband Receiver Front-End for Short Range Wireless Applications

The demand for radio frequency (RF) transceivers operating at 2.4 GHz band has attracted considerable research interest due to the advancement in short range wireless technologies. The performance of RF transceivers depends heavily on the transmitter and receiver front-ends. The receiver front-end is comprised of a low-noise amplifier (LNA) and a downconversion mixer. There are very few designs that focus on connecting the single-ended output LNA to a double-balanced mixer without the use of on-chip transformer, also known as a balun. The objective of designing such a receiver front-end is to achieve high integration and low power consumption. To meet these requirements, we present the design of fully-integrated 2.4 GHz receiver front-end, consisting of a narrow-band LNA and a double balanced mixer without using a balun. Here, the single-ended RF output signal of the LNA is translated into differential signal using an NMOS-PMOS (n-channel metal-oxide-semiconductor, p-channel metal-oxide-semiconductor) transistor differential pair instead of the conventional NMOS-NMOS transistor configuration, for the RF amplification stage of the double-balanced mixer. The proposed receiver circuit fabricated using TSMC 0.18 µm CMOS technology operates at 2.4 GHz and produces an output signal at 300 MHz. The fabricated receiver achieves a gain of 16.3 dB and consumes only 6.74 mW operating at 1.5 V, while utilizing 2.08 mm2 of chip area. Measurement results demonstrate the effectiveness and suitability of the proposed receiver for short-range wireless applications, such as in wireless sensor network (WSN)

A Proposed Scalable Design and Simulation of Wireless Sensor Network-Based Long-Distance Water Pipeline Leakage Monitoring System

Anomalies such as leakage and bursts in water pipelines have severe consequences for the environment and the economy. To ensure the reliability of water pipelines, they must be monitored effectively. Wireless Sensor Networks (WSNs) have emerged as an effective technology for monitoring critical infrastructure such as water, oil and gas pipelines. In this paper, we present a scalable design and simulation of a water pipeline leakage monitoring system using Radio Frequency IDentification (RFID) and WSN technology. The proposed design targets long-distance aboveground water pipelines that have special considerations for maintenance, energy consumption and cost. The design is based on deploying a group of mobile wireless sensor nodes inside the pipeline and allowing them to work cooperatively according to a prescheduled order. Under this mechanism, only one node is active at a time, while the other nodes are sleeping. The node whose turn is next wakes up according to one of three wakeup techniques: location-based, time-based and interrupt-driven. In this paper, mathematical models are derived for each technique to estimate the corresponding energy consumption and memory size requirements. The proposed equations are analyzed and the results are validated using simulation

Selectively grown GaAs nanodisks on Si(100) by molecular beam epitaxy

The authors report the molecular beam epitaxial growth and the structural and optical characterizations of self-assembled/catalyst-free GaAs nanodisks on SiO2 masked Si(100) patterned substrates. Pure zincblende GaAs nanodisks with precise positioning and low defect density are demonstrated by selective area epitaxy. The influence of the growth temperature and deposition duration is investigated. Excellent morphological and structural properties are characterized by scanning electron microscopy and cross-sectional transmission electron microscopy. Defects in the epilayers are reduced by strain relaxation through facets formation and by a lateral overgrowth scheme atop the SiO2 mask which is corroborated by microRaman spectroscopy. In particular, the authors show how the material quality contributes to excellent optical properties observed by microphotoluminescence spectroscopy from 77 K to room temperature. (C) 2014 American Vacuum Society

Investigation of source position uncertainties & balloon deformation in MammoSite brachytherapy on treatment effectiveness

The MammoSite® breast high dose rate brachytherapy is used in treatment of early-stage breast cancer. The tumour bed volume is irradiated with high dose per fraction in a relatively small number of fractions. Uncertainties in the source positioning and MammoSite balloon deformation will alter the prescribed dose within the treated volume. They may also expose the normal tissues in balloon proximity to excessive dose. The purpose of this work is to explore the impact of these two uncertainties on the MammoSite dose distribution in the breast using dose volume histograms and Monte Carlo simulations. The Lyman–Kutcher and relative seriality models were employed to estimate the normal tissues complications associated with the MammoSite dose distributions. The tumour control probability was calculated using the Poisson model. This study gives low probabilities for developing heart and lung complications. The probability of complications of the skin and normal breast tissues depends on the location of the source inside the balloon and the volume receiving high dose. Incorrect source position and balloon deformation had significant effect on the prescribed dose within the treated volume. A 4 mm balloon deformation resulted in reduction of the tumour control probability by 24%. Monte Carlo calculations using EGSnrc showed that a deviation of the source by 1 mm caused approximately 7% dose reduction in the treated target volume at 1 cm from the balloon surface. In conclusion, accurate positioning of the 192Ir source at the balloon centre and minimal balloon deformation are critical for proper dose delivery with the MammoSite brachytherapy applicator. On the basis of this study, we suggest that the MammoSite treatment protocols should allow for a balloon deformation of ≤2 mm and a maximum source deviation of ≤1 mm.S. Bensaleh, E. Beza