UK adaptive radiotherapy practices for head and neck cancer patients

Objective: To provide evidence on the extent and manner in which adaptive practices have been employed in the UK and identify the main barriers for the clinical implementation of adaptive radiotherapy (ART) in head and neck (HN) cancer cases. Methods: In December 2019, a Supplementary Material 1, of 23 questions, was sent to all UK radiotherapy centres (67). This covered general information to current ART practices and perceived barriers to implementation. Results: 31 centres responded (46%). 56% responding centres employed ART for between 10 and 20 patients/annum. 96% of respondents were using CBCT either alone or with other modalities for assessing "weight loss" and "shell gap," which were the main reasons for ART. Adaptation usually occurs at week three or four during the radiotherapy treatment. 25 responding centres used an online image-guided radiotherapy (IGRT) approach and 20 used an offline ad hoc ART approach, either with or without protocol level. Nearly 70% of respondents required 2 to 3 days to create an adaptive plan and 95% used 3-5 mm adaptive planning target volume margins. All centres performed pre-treatment QA. "Limited staff resources" and "lack of clinical relevance" were identified as the two main barriers for ART implementation. Conclusion: There is no consensus in adaptive practice for HN cancer patients across the UK. For those centres not employing ART, similar clinical implementation barriers were identified. Advances in knowledge: An insight into contemporary UK practices of ART for HN cancer patients indicating national guidance for ART implementation for HN cancer patients may be required

Antennal Phenotype of Triatoma dimidiata Populations and Its Relationship with Species of phyllosoma and protracta Complexes

Triatoma dimidiata (Latreille 1811) Reduviidae Triatominae is the main vector of Chagas disease in several countries of Latin America. As for other vector species, the characterization of T. dimidiata subpopulations within particular geographical regions or occupying different habitats could help in better planning of vector control actions. A Þrst objective in this study was to evaluate the antennal phenotype as a phenetic marker to characterize populations of T. dimidiata collected in different geographic areas and domestic and sylvatic habitats. A second objective was to evaluate the phenetic relationships of T. dimidiata with other species of the phyllosoma complex: longipennis, pallidipennis, and phyllosoma. The antennal sensilla of T. dimidiata specimens collected in Mexico, Central America, and Colombia were analyzed and compared with the antennal sensilla of T. longipennis, T. pallidipennis, and T. phyllosoma. T. barberi was used as an outgroup in the analysis. For each specimen, the ventral side of the three distal segments of the antennae was drawn, identifying and counting four types of sensilla. In T. dimidiata, univariate and multivariate analysis showed differences between sexes, among populations collected in different habitats within the same region, and among populations collected in different geographic regions. Two types of antennal sensilla showed a latitudinal variation. Domestic specimens showed intermediate characteristics of the antennal phenotype, between sylvatic cave- and sylvatic forest-collected specimens. The antennal phenotypes show high similarities among T. pallidipennis, T. phyllosoma, and T. longipennis, with a better differentiation of T. pallidipennis. T. dimidiata is separated from the other members of the complex by a similar distance to T. barberi, of the protracta complex.Fil: Catala, Silvia Susana. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Regional de Investigaciones Científicas y Transferencia Tecnológica de La Rioja. - Universidad Nacional de La Rioja. Centro Regional de Investigaciones Científicas y Transferencia Tecnológica de La Rioja. - Universidad Nacional de Catamarca. Centro Regional de Investigaciones Científicas y Transferencia Tecnológica de La Rioja. - Secretaría de Industria y Minería. Servicio Geológico Minero Argentino. Centro Regional de Investigaciones Científicas y Transferencia Tecnológica de La Rioja. - Provincia de La Rioja. Centro Regional de Investigaciones Científicas y Transferencia Tecnológica de La Rioja; ArgentinaFil: Sachetto, C.. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Regional de Investigaciones Científicas y Transferencia Tecnológica de La Rioja. - Universidad Nacional de La Rioja. Centro Regional de Investigaciones Científicas y Transferencia Tecnológica de La Rioja. - Universidad Nacional de Catamarca. Centro Regional de Investigaciones Científicas y Transferencia Tecnológica de La Rioja. - Secretaría de Industria y Minería. Servicio Geológico Minero Argentino. Centro Regional de Investigaciones Científicas y Transferencia Tecnológica de La Rioja. - Provincia de La Rioja. Centro Regional de Investigaciones Científicas y Transferencia Tecnológica de La Rioja; ArgentinaFil: Moreno, Mariana Laura. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Regional de Investigaciones Científicas y Transferencia Tecnológica de La Rioja. - Universidad Nacional de La Rioja. Centro Regional de Investigaciones Científicas y Transferencia Tecnológica de La Rioja. - Universidad Nacional de Catamarca. Centro Regional de Investigaciones Científicas y Transferencia Tecnológica de La Rioja. - Secretaría de Industria y Minería. Servicio Geológico Minero Argentino. Centro Regional de Investigaciones Científicas y Transferencia Tecnológica de La Rioja. - Provincia de La Rioja. Centro Regional de Investigaciones Científicas y Transferencia Tecnológica de La Rioja; ArgentinaFil: Rosales, R.. Universidad de San Carlos; GuatemalaFil: Salazar Schettino, P. M.. Universidad Nacional Autónoma de México; MéxicoFil: Gorla, David Eladio. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Regional de Investigaciones Científicas y Transferencia Tecnológica de La Rioja. - Universidad Nacional de La Rioja. Centro Regional de Investigaciones Científicas y Transferencia Tecnológica de La Rioja. - Universidad Nacional de Catamarca. Centro Regional de Investigaciones Científicas y Transferencia Tecnológica de La Rioja. - Secretaría de Industria y Minería. Servicio Geológico Minero Argentino. Centro Regional de Investigaciones Científicas y Transferencia Tecnológica de La Rioja. - Provincia de La Rioja. Centro Regional de Investigaciones Científicas y Transferencia Tecnológica de La Rioja; Argentin

Recursive Selective Harmonic Elimination for Multilevel Inverters: Mathematical Formulation and Experimental Validation

A recursive method that eliminates +1 harmonics and their respective multiples from the output voltage of a cascaded H-bridge multilevel inverters with = 2 dc sources ( = 1, 2, 3,...) is proposed. It solves 2×2 linear systems with not singular matrices and always gives an exact solution with very low computational effort. Simulated results in three-phase five, nine, seventeen and thirty three level CHB inverters, and experimental results in five-level inverter demonstrate the validity of the method

Impact Evaluation of Innovative Selective Harmonic Mitigation Algorithm for Cascaded H-Bridge Inverter on IPMSM Drive Application

This paper presents a detailed analysis of the use of a novel Harmonic Mitigation algorithm for Cascaded H-Bridge Multilevel Inverter in electrical drives for the transportation field. For this purpose, an enhanced mathematical model of Interior Permanent Magnet Synchronous Motor (IPMSM), that takes into account simultaneously saturation, cross-coupling, spatial harmonics, and iron loss effects, has been used. In detail, this model allows estimating accurately the efficiency and the torque ripple of the IPMSM, crucial parameters for transportation applications. Moreover, two traditional pulse width modulation strategies, Sinusoidal Phase-Shifted and Switching Frequency Optimal Phase-Shifted have been considered for comparison purposes with an optimized harmonic mitigation algorithm. Thus, this work provides a deep analysis of IPMSM drive performance fed by CHBMI, paying attention to various aspects such as the IPMSM efficiency, torque ripple, current, and voltage total harmonic distortion (THD). Finally, experimental investigations have been carried out to validate the analysis conducted

Rapid extraction of emotion regularities from complex scenes in the human brain

Adaptive behavior requires the rapid extraction of behaviorally relevant information in the environment, with particular emphasis on emotional cues. However, the speed of emotional feature extraction from complex visual environments is largely undetermined. Here we use objective electrophysiological recordings in combination with frequency tagging to demonstrate that the extraction of emotional information from neutral, pleasant, or unpleasant naturalistic scenes can be completed at a presentation speed of 167 ms (i.e., 6 Hz) under high perceptual load. Emotional compared to neutral pictures evoked enhanced electrophysiological responses with distinct topographical activation patterns originating from different neural sources. Cortical facilitation in early visual cortex was also more pronounced for scenes with pleasant compared to unpleasant or neutral content, suggesting a positivity offset mechanism dominating under conditions of rapid scene processing. These results significantly advance our knowledge of complex scene processing in demonstrating rapid integrative content identification, particularly for emotional cues relevant for adaptive behavior in complex environments

Cross-cultural adaptation and validation of the voice handicap index into Italian

Objectives. To evaluate the internal consistency, reliability, and clinical validity of the Italian version of the Voice Handicap Index (VHI). Study Design. Cross-sectional survey study was carried out. Methods. One hundred and seventy-five patients with voice disorders, divided in four groups according to the etiology of the disease (neurogenic, structural, functional, and inflammatory), and 84 asymptomatic subjects were included in the study. Internal consistency was analyzed through Cronbach alpha coefficient. For the VHI test-retest reliability analysis, the Italian VHI was filled twice by 56 patients and 56 control subjects. The test-retest reliability was assessed through the Pearson correlation test. For the clinical validity assessment, the scores obtained in the pathological group were compared with those found in asymptomatic individuals through the Kruskal-Wallis test. Also, the correlation between VHI and the grade of voice disorder was assessed. Finally, the effect of age and gender on overall VHI and its three subscales was analyzed. Results. Optimal internal consistency was found (alpha = 0.93); the test-retest reliability in both groups was high (r > 0.86). Nonparametric Kruskal-Wallis analysis of variance for the overall VHI score and its three domains revealed a significant main effect for group (P = 0.000). The control group scored significantly lower than the four groups of voice-disordered patients. The overall VHI score positively correlated with the grade of voice disorder (r = 0.43). In the voice-disorder group, age and gender were not correlated to the overall VHI score and to their three domains. Conclusion. The Italian VHI is highly reproducible, and exhibits excellent clinical validity

Dead-time impact on the harmonic distortion and conversion efficiency in a three-phase five-level Cascaded H-Bridge inverter: mathematical formulation and experimental analysis

To avoid leg short-circuit in inverters, dead time must be introduced on leg gate signals. Dead time affects the inverter output voltage fundamental harmonic amplitude, voltage harmonic distortion and inverter efficiency by introducing additional voltage drops. In this regard, dead time effects have been widely investigated for traditional two-level three-phase voltage source inverters in the literature but not extensively for multilevel topology structures. This paper provides a detailed analysis of dead time impact on the harmonic distortion and efficiency of Cascaded H-Bridges Multilevel Inverters (CHBMIs). For this purpose, a general mathematical formulation to determine voltage drop due to dead time effects, also taking into account the adopted Multicarrier PWM strategy, has been provided and experimentally validated for a five-level three-phase CHBMI structure. As a comparison tool between expected and ideal inverter output voltage, the percentage voltage error e% is introduced. In most of the cases, e% is lower than 5%, and it starts increasing for very low amplitude modulation index or for specific working points where nonlinearities occur. Furthermore, several experimental investigations have been carried out to evaluate the CHBMI performance in terms of harmonic distortion and efficiency by changing, the values of dead time, modulation index and switching frequency for ten different multi-carried PWM strategies. Experimental results confirm the strong dependency between the dead time impact on the converter performance and the adopted Multi Carrier-PWM (MC-PWM) strategy: as a way of example, converter efficiency can be reduced from 80% to 60% when dead time is increased from 0.5 μs to 1.5 μs and Phase Shifted-PWM (PS-PWM) is adopted