b→sℓ+ℓ−b\to s\ell^+\ell^- Transitions in Two-Higgs-Doublet Models

In this article we study $b\to s\mu^+\mu^-$ transitions and possible correlations with the anomalous magnetic moment of the muon ($a_\mu$) within two-Higgs-doublet models with generic Yukawa couplings, including the possibility of right-handed neutrinos. We perform the matching on the relevant effective Hamiltonian and calculate the leading one-loop effects for $b\to s\ell\ell^{(\prime)}$, $b\to s\gamma$, $\Delta B=\Delta S=2$, $b\to s\nu\bar\nu$ and $\ell\to\ell^\prime\gamma$ transitions in a general $R_\xi$ gauge. Concerning the phenomenology, we find that an explanation of the hints for new physics in $b\to s\mu^+\mu^-$ data is possible once right-handed neutrinos are included. If lepton flavour violating couplings are allowed, one can account for the discrepancy in $a_\mu$ as well. However, only a small portion of parameter space gives a good fit to $b\to s\mu^+\mu^-$ data and the current bound on $h\to\tau\mu$ requires the mixing between the neutral Higgses to be very small if one aims at an explanation of $a_\mu$.Comment: 40 pages, 1 table, 10 figure

Malignant Vascular Tumors of the Head and Neck—Which Type of Therapy Works Best?

Malignant vascular tumors of the head and neck are rare neoplasms with variable clinical presentation, wide age distribution, and variable clinical courses. The heterogeneous presentation of angiosarcomas and epithelioid hemangioendothelioma often leads to misdiagnosis and unsuitable treatment. While risk factors for angiosarcomas are previous radiation, chronic lymphedema, and exposure to arsenic, thorium oxide, or vinyl chloride, there are only limited and retrospective data available on prognostic factors in EHE. In both angiosarcomas and EHE, surgery is the mainstay of treatment. There is limited evidence regarding the role of radiotherapy in EHE, although EHE is considered relatively radiosensitive. In angiosarcomas, adjuvant radiotherapy is recommended according to retrospective case series. A standard medical therapy for metastasized malignant vascular tumors is lacking. Chemotherapy, which is effective in angiosarcoma, is mostly ineffective in EHE. Targeted therapy, antiangiogenetic drugs and immunotherapy have been studied as new treatment options. The goal of this review is to summarize the current data regarding malignant vascular tumors along with their diagnosis and management

Course of Self-Reported Dysphagia, Voice Impairment and Pain in Head and Neck Cancer Survivors

Background: Head and neck cancer (HNC)-specific symptoms have a substantial impact on health-related quality of life. The aim of this study was to determine whether self-reported dysphagia, voice problems and pain of HNC patients changed over time and whether specific clinical or sociodemographic variables were associated with these symptoms. Methods: HNC patients (n = 299) in an outpatient setting answered questionnaires (Eating Assessment Tool-10; questions from the EORTC QLQ-C30 and EORTC H&N35) on dysphagia, voice problems and pain, collected with the software “OncoFunction” at three different timepoints (t1–t3) after diagnosis. The mean score changes from t1 to t3 were expressed in terms of effect sizes d. The impact of sociodemographic and clinical factors on the course of the variables was tested with multivariate analyses of variance. Results: Dysphagia, voice impairment and pain in HNC survivors significantly improved over a period of approximately 14 months after diagnosis. Tumor site, stage, treatment modality, occupational state and ECOG state were significantly correlated with self-reported functional outcome. The pain level of the HNC patients was rather low. Conclusions: Patients suffer from functional impairments after HNC treatment, but an improvement in self-reported symptoms could be demonstrated within this time period

Perspectives of Induction With Chemo and/or Immune Check Point Inhibition in Head and Neck Organ Preservation Treatment

Induction chemotherapy (ICT) is an attractive option for advanced head and neck squamous cell carcinoma (HNSCC) patients which has been prospectively evaluated in the context of a multimodality treatment approach. The theoretical benefit is the ability to suppress distant metastases and shrink the tumor while chemotherapy is better tolerated when given sequentially than concurrently. However, clinical trials have failed to show consistent benefit of ICT over concurrent radio-chemotherapy and due to so far lacking level 1 evidence ICT outside larynx organ preservation remains rather investigational. Immune modulation by inhibition of immune checkpoints is an exciting recent development in HNSCC which has mainly been investigated as second line treatment after progression on platinum-based chemotherapy in patients with recurrent/metastatic HNSCC. Due to the promising results in these trials and even more in the first-line trial KEYNOTE-048 and encouraging first preliminary results of preoperative Anti-PD1-application, the role of neoadjuvant immunotherapy is currently under investigation in HNSCC

Choosing the Right Treatment Option for the Right R/M HNSCC Patient: Should We Adhere to PFE for First-Line Therapy?

Background: The landmark EXTREME trial established cisplatin, 5-fluorouracil and cetuximab (PFE) as first-line chemotherapy (1L-ChT) for recurrent/metastatic head and neck squamous cell carcinoma (R/M HNSCC). We were interested in outcome differences of R/M HNSCC in 1L-ChT and factors influencing outcome in certain subgroups, especially patients receiving PFE, and the value of PFE compared to other 1L-ChT regimens to provide real world evidence (RWE). Methods: For this retrospective monocentric study, 124 R/M HNSCC patients without curative surgical or radiotherapy options receiving at least one cycle of 1L-ChT were eligible. We analyzed their outcome using Kaplan-Meier plot and Cox regression to identify predictors for prolonged survival. Results: Subgroups benefiting significantly from PFE were patients suffering from an index HNSCC outside the oropharynx. The PFE regimen proved to be superior to all other 1L-ChT regimens in clinical routine. Significant outcome differences between PFE treatment within or outside controlled trials were not seen. Conclusion: This retrospective analysis provides RWE for factors linked to improved outcome. Subgroup analyses highlight the lasting value of PFE among the growing spectrum of 1L-ChT. Importantly, fit smokers with high level alcohol consumption benefit from PFE; considering the patient’s lifestyle factors, PFE should not be ignored in decision-making

Systematische Berücksichtigung der EMV beim Entwurf von induktiven Energieübertragungssystemen

Induktive Energieübertragungssysteme bieten insbesondere im Bereich der Elektromobilität große Vorteile bei der Nutzerfreundlichkeit. Da hier Leistungen von mehreren Kilowatt kabellos übertragen werden, ist ein sorgfältiger Entwurf der Systeme hinsichtlich der Elektromagnetischen Verträglichkeit notwendig. Hierbei sind insbesondere die Störaussendung und Personenschutzgrenzwerte zu berücksichtigen. Der Vortrag beschreibt hierbei den Entwurfsprozess zur induktiven Energieübertragung hinsichtlich der EMV sowie in diesem Rahmen durchgeführte Messungen. Berücksichtigt werden hierbei theoretische Betrachtungen zur Systemauslegung. Da insbesondere die Spulengeometrien der magnetischen Strecken die Störaussendung maßgeblich beeinflussen, wurden verschiedene Simulationen inklusive der magnetischen Felder im Be-reich der Störaussendung und der Personenschutzgrenzwerte durchgeführt. Basierend auf diesen Untersuchungen wurden mehrere Prototypen aufgebaut. Diese Prototypen berücksichtigen verschiedene Konfigurationen der magnetischen Strecken. Zur Evaluation der Prototypen wurden Störaussendungsmessungen durchgeführt. Da es zum Zeitpunkt der Messungen noch keine normativen Messverfahren für induktive Energieübertragungssysteme gab, lag ein Aspekt auf der Auswahl der geeigneten Messverfahren und Messaufbauten

Exploratory study of functional and psychological factors associated with employment status in patients with head and neck cancer

Background Compared with other malignancies, head and neck cancer (HNC) increases the risk of not returning to work (RTW). Methods Within a cross-sectional study, patients with HNC filled out the OncoFunction questionnaire, a version of the International Classification of Functioning Core Sets for HNC. In 231 patients below 65 years of age, associations of sociodemographic, clinical, functional, and psychological factors with employment and participation in rehabilitation program were explored. Results Unemployed patients reported more swallowing difficulties and speaking problems. Being unemployed was associated with higher levels of depressive and anxiety symptoms, fatigue, and lower global health. Rehabilitation participation was not significantly associated with any of the assessed factors except for smoking. Conclusions Unemployed patients with HNC are more burdened than employed patients with HNC regarding clinical, psychological, and functional factors. These differences are more evident later in recovery. Rehabilitation participation was not associated with psychological and functional burden which indicates the need for tailored HNC rehabilitation programs

FPGA-basierte aktive Unterdrückung der elektromagnetischen Störungen einer aktiven Leistungsfaktorkorrektur (PFC) durch die Injektion von modulierten Sinussignalen

Eine aktive Leistungsfaktorkorrektur (englisch: Power Factor Correction, PFC) ist eine typische Eingangsstufe vieler am Stromnetz betriebenen Geräte. Die aktive PFC sorgt durch geeignete Regelkreise für eine Stromentnahme, welche die gleiche Kurvenform und Phasenlage wie die Netzspannung besitzt. Dadurch kommt es zu einer Minimierung der Blind- und Verzerrungsleistung und zu einer Maximierung des namensgebenden Leistungsfaktors. Der Ausgang der PFC ist dabei in der Regel eine Gleichspannung. In aktiven PFCs werden üblicherweise hochfrequent schaltende Transistoren eingesetzt. Diese Schaltvorgänge sorgen für elektromagnetische Störungen, welche sich sowohl leitungsgebunden als auch abgestrahlt ausbreiten können. Die daraus resultierende Störemission muss reduziert werden, damit es zu keinen Funktionsbeeinträchtigungen anderer Geräte kommt. Zur Reduktion der ins Netz einkoppelnden leitungsgebundenen Störungen werden üblicherweise passive Filterstrukturen eingesetzt, welche jedoch häufig groß, schwer und teuer sind. Aktive Verfahren zur Störunterdrückung können zu einer Reduktion des Filteraufwands beitragen und damit bauraum- und gewichtsreduzierte Systeme ermöglichen. Im Rahmen des Beitrags wird ein neues aktives Verfahren vorgestellt, um gezielt einzelne Schaltharmonische mithilfe von jeweils einem modulierten Sinussignal zu unterdrücken. Einleitend werden aktive EMV-Filter und die Störunterdrückung mithilfe von synthetisierten und synchronisierten Gegenstörsignalen als zwei Verfahren zur aktiven Störunterdrückung vorgestellt. Das zweite Verfahren wird im Rahmen dieses Beitrags erstmalig auf eine PFC angewendet. Es wird herausgearbeitet, dass die Störungen der betrachteten PFC aus modulierten Schaltharmonischen bestehen. Damit kann eine aktive Störunterdrückung durch eine Injektion von modulierten Sinussignalen erfolgen. Zur Realisierung wird eine selbstadaptierende Methode aus der aktiven Lärmkompensation (Akustik) auf einem FPGA-System implementiert und systematisch für die Anwendung auf die PFC untersucht. Die optimierte Implementierung wird anhand einer realen PFC evaluiert. Der Beitrag endet mit einer Zusammenfassung und einem Ausblick

Obtaining Patient-Reported Outcomes Electronically With “OncoFunction” in Head and Neck Cancer Patients During Aftercare

The disease and treatment of patients with head and neck cancer can lead to multiple late and long-term sequelae. Especially pain, psychosocial problems, and voice issues can have a high impact on patients’ health-related quality of life. The aim was to show the feasibility of implementing an electronic Patient-Reported Outcome Measure (PROM) in patients with head and neck cancer (HNC). Driven by our department’s intention to assess Patient-Reported Outcomes (PRO) based on the International Classification of Functioning during tumor aftercare, the program “OncoFunction” has been implemented and continuously refined in everyday practice. The new version of “OncoFunction” was evaluated by 20 head and neck surgeons and radiation oncologists in an interview. From 7/2013 until 7/2017, 846 patients completed the PROM during 2,833 of 3,610 total visits (78.5%). The latest software version implemented newly developed add-ins and increased the already high approval ratings in the evaluation as the number of errors and the time required decreased (6 vs. 0 errors, 1.35 vs. 0.95 min; p<0.01). Notably, patients had different requests using PRO in homecare use. An additional examination shows that only 59% of HNC patients use the world wide web. Using OncoFunction for online-recording and interpretation of PROM improved data acquisition in daily HNC patients’ follow-up. An accessory timeline grants access to former consultations and their visualization supported and simplified structured examinations. This provides an easy-to-use representation of the patient’s functional outcome supporting comprehensive aftercare, considering all aspects of the patient’s life