Effects and moderators of psychosocial interventions on quality of life, and emotional and social function in patients with cancer : an individual patient data meta-analysis of 21 RCTs

Objective: This individual patient data (IPD) meta‐analysis aimed to evaluate the effects of psychosocial interventions (PSI) on quality of life (QoL), emotional function (EF), and social function (SF) in patients with cancer, and to study moderator effects of demographic, clinical, personal, and intervention‐related characteristics. Methods: Relevant studies were identified via literature searches in 4 databases. We pooled IPD from 22 (n = 4217) of 61 eligible randomized controlled trials. Linear mixed‐effect model analyses were used to study intervention effects on the post‐intervention values of QoL, EF, and SF (z‐scores), adjusting for baseline values, age, and cancer type. We studied moderator effects by testing interactions with the intervention for demographic, clinical, personal, and intervention‐related characteristics, and conducted subsequent stratified analyses for significant moderator variables.Results: PSI significantly improved QoL (β = 0.14,95%CI = 0.06;0.21), EF (β = 0.13,95%CI = 0.05;0.20), and SF (β = 0.10,95%CI = 0.03;0.18). Significant differences in effects of different types of PSI were found, with largest effects of psychotherapy. The effects of coping skills training were moderated by age, treatment type, and targeted interventions. Effects of psychotherapy on EF may be moderated by cancer type, but these analyses were based on 2 randomized controlled trials with small sample sizes of some cancer types. Conclusions: PSI significantly improved QoL, EF, and SF, with small overall effects. However, the effects differed by several demographic, clinical, personal, and intervention‐related characteristics. Our study highlights the beneficial effects of coping skills training in patients treated with chemotherapy, the importance of targeted interventions, and the need of developing interventions tailored to the specific needs of elderly patients

Online Longitudinal Bunch Profile and Slice Emittance Diagnostics at the European XFEL

The longitudinal current profile and slice emittance are important bunch parameters for the operation of an X-ray free-electron laser. At the European XFEL, dedicated diagnostic sections equipped with transverse deflecting RF structures (TDS) have been installed for the control and optimisation of these parameters. Travelling-wave TDS in combination with fast kicker magnets and off-axis screens allow for the study of individual bunches without affecting the other bunches in the super-conducting linear accelerator which can generate bunch trains of up to 2700 bunches at 4.5 MHz within 600 microsecond RF pulses at a repetition rateof 10 Hz. The measurement of the slice emittance is realised in a static F0D0 lattice equipped with four individual screen stations.Variations of the longitudinal bunch profile or slice emittance along the bunch train may lead to degraded FEL performance for parts of the train which reduces the effective available number of bunches for FEL operation. By gradually adjusting the timing, individual bunches along the bunch train can be measured in order to optimise the overall beam parameters for all bunches in the train. In this paper, we describe in detail the diagnostic concept and present first measurement results of the projected and slice emittance along the bunch train

FIRST REALIZATION AND PERFORMANCE STUDY OF A SINGLE-SHOT LONGITUDINAL BUNCH PROFILE MONITOR UTILIZING A TRANSVERSE DEFLECTING STRUCTURE

Abstract For the control and optimization of electron beam parameters at modern free-electron lasers (FEL), transverse deflecting structures (TDS) in combination with imaging screens have been widely used as robust longitudinal diagnostics with single-shot capability, high resolution and large dynamic range. At the free electron laser in Hamburg (FLASH), a longitudinal bunch profile monitor utilizing a TDS has been realized. In combined use with a fast kicker magnet and an off-axis imaging screen, selection and measurement of a single bunch out of the bunch train with bunch spacing down to 1 µs can be achieved without affecting the remaining bunches which continue to generate FEL radiation during user operation. Technical obstacles have been overcome such as suppression of coherent transition radiation from the imaging screen, the continuous image acquisition and processing with the bunch train repetition rate of 10 Hz. The monitor, which provides the longitudinal bunch profile and length, has been used routinely at FLASH. In this paper, we present the setup and operation of the longitudinal bunch profile monitor as well as its performance during user operation

Design and Test of a Fast Feedbacksystem for Orbit Correction at TTF and the TESLA Linear Collider

To achieve high luminosity in the TESLA Linear Collider feedback systems will be needed to provide orbit corrections within the bunch train. A prototype of the complete vertical feedback system has been installed in the TESLA Test Facility at DESY. The use of digital signal processing techniques led to a fast and highly flexible solution for the controller function. Additional features such as data logging and analysis allow easyadjustment of the feedback parameters to achieve the optimum performance of the system. An overview of the system will be presented as well as the results of first measurements

Multi-Beamline Operation at the European XFEL

The European XFEL uses a unique beam distribution scheme to direct electron bunches to its three undulator lines.The accelerator delivers up to 600 microsecond long bunchtrains, out of which parts or individual bunches can be selectedfor photon production in any of the FELs. This contribution gives a brief overview of the kicker-septum scheme facilitating this and highlights how even complex bunch patterns can easily be configured via the timing system

FLASHlab@PITZ: New R&D platform with unique capabilities for electron FLASH and VHEE radiation therapy and radiation biology under preparation at PITZ.

At the Photo Injector Test facility at DESY in Zeuthen (PITZ), an R&D platform for electron FLASH and very high energy electron radiation therapy and radiation biology is being prepared (FLASHlab@PITZ). The beam parameters available at PITZ are worldwide unique. They are based on experiences from 20 + years of developing high brightness beam sources and an ultra-intensive THz light source demonstrator for ps scale electron bunches with up to 5 nC bunch charge at MHz repetition rate in bunch trains of up to 1 ms length, currently 22 MeV (upgrade to 250 MeV planned). Individual bunches can provide peak dose rates up to 10 <sup>14</sup> Gy/s, and 10 Gy can be delivered within picoseconds. Upon demand, each bunch of the bunch train can be guided to a different transverse location, so that either a "painting" with micro beams (comparable to pencil beam scanning in proton therapy) or a cumulative increase of absorbed dose, using a wide beam distribution, can be realized at the tumor. Full tumor treatment can hence be completed within 1 ms, mitigating organ movement issues. With extremely flexible beam manipulation capabilities, FLASHlab@PITZ will cover the current parameter range of successfully demonstrated FLASH effects and extend the parameter range towards yet unexploited short treatment times and high dose rates. A summary of the plans for FLASHlab@PITZ and the status of its realization will be presented