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This paper introduces an optimised design procedure for a DC–DC buck, boost and buck-boost configurations in a single circuit with an integrated dissipative snubber, aiming to enhance performance and efficiency. The conventional buck-boost converter’s versatility in adjusting the output voltage is complemented by a dissipative snubber, mitigating hard switching challenges in power semiconductors. Utilising advanced control techniques for seamless transitions between step-down and step-up modes, the proposed circuit ensures optimal operation across varying input voltages. The research delves into the snubber’s impact on limiting the maximum voltage stress across the switch, considering power losses in the snubber resistor. Simulation, analysis and experimental results validate the design’s effectiveness in meeting voltage regulation requirements, showcasing its adaptability to diverse electronic applications. This optimised design methodology holds promise for improving DC–DC converter efficiency in practical applications where mitigating switching losses and optimising voltage stress are critical considerations. Also this proposed converter provides output simultaneously for buck and boost configurations. The simulation and mathematical analysis are validated using the experimental prototype. [ABSTRACT FROM AUTHOR]

In the cascaded H - bridge multilevel SVG (Static Var Generator), the inherent structural characteristics of the H - bridge lead to the presence of secondary ripple in the DC side capacitor voltage of the angular cascaded SVG, and the voltage ripple affect the degree of compensation of power quality and even lead to system dysregulation. In order to suppress the secondary ripple of the voltage on the H - bridge DC side of the angular cascaded SVG, this study proposes a design solution for the angular cascaded H - bridge multilevel SVG based on Boost type active power decoupling. The APD (Active Power Decoupling) circuit separates fluctuating power and stable power from each other and uses energy storage elements to absorb fluctuating power, which weakens the voltage ripple on the DC side of the H-bridge. The simulation platform was built and simulated using MATLAB/Simulink software. The simulation results show that the angular cascaded H - bridge multilevel SVG based on Boost type active power decoupling can effectively suppress the secondary ripple of the voltage of the DC side capacitor. [ABSTRACT FROM AUTHOR]

Whether brachytherapy based microboosting of the dominant intraprostatic lesion (DIL) improves outcomes over standard approaches is not known. The purpose of this study is to perform a systematic review on brachytherapy microboosting of the DIL to evaluate clinical outcomes and toxicities with this treatment approach. This review was performed according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Databases including Pubmed, Embase, and Google Scholar were queried. About 16 studies met our inclusion criteria. These studies reported PSA control and/or toxicities based on standardized scales. There were 10 studies (two monotherapy, eight combination) that used HDR microboosting on a total of 516 patients. HDR dose (EQD2 assuming alpha/beta of 1.5) to the DIL ranged from 90 to 180 Gy. Most patients were low/intermediate risk. PSA control rates at 5–8 years ranged from 69% to 100%. Acute/late G3-G4 GU/GI toxicities ranged from 0% to 12%. There were six studies (five monotherapy, one combination) that used LDR microboosting on a total of 1041 patients. Studies performed a microboost of 130–150% of the whole gland prescription to the DIL. Most patients were low/intermediate risk. PSA control rates at 5 years ranged from 69% to 98%. Acute/late G3–4 GU/GI toxicities ranged from 0% to 4%. Over 1000 patients have been treated with a brachytherapy based microboost in published series. Severe acute/late toxicities appear limited. PSA control rates with more than 5 years of follow-up are limited. Longer-term follow-up is needed to determine ideal utilization of this approach. [ABSTRACT FROM AUTHOR]

This paper presents a design and analysis of novel DC-DC boost converter with a least component count. The proposed converter produces high DC gain voltage in comparison to some recently presented high voltage DC-DC converter. Here one switch, one inductor, two capacitors and one diode are used to achieved a high voltage gain without compromising efficiency of converter. The converter’s performance is evaluated using theatrical, simulation and experimental methods, with results indicating a four times of input voltage and a fast-transient response at various duty cycles is achieved. Due to its low component count the proposed converter is compact and hence it offers an effective solution for various power applications. [ABSTRACT FROM AUTHOR]

The paper proposed a boost five-level inverter for wireless power transfer (WPT) system. It consists of one DC source, one inductor, one capacitor, and six power switches. It can produce a five-level output with an amplitude twice that of the DC source voltage. Compared with the existing five-level inverters, the proposed topology needs fewer power switches and energy storage elements, as well as lower power switches total standing voltage. Firstly, this paper introduced the topology and operating principle of the proposed inverter, established the mathematical models of the inverter output voltage and the system output power, and compared the proposed inverter with the existing five-level inverters. On this basis, the level cascaded extension method and topology of the proposed inverter were introduced and analyzed. Then, the modulation strategy and parameters of the proposed inverter were designed. Furthermore, the power loss of the proposed inverter was calculated. Finally, simulation and experimental verification were conducted. The results show that the inverter efficiency can reach up to about 94.5%, and the output THD can be as low as 24.47% or even lower. In addition, the transient response time is within 4 ms, proving the feasibility and superiority of the proposed inverter applied to WPT systems. [ABSTRACT FROM AUTHOR]

PARVAX is a genetic vaccine platform based on an adeno-associated vector that has demonstrated to elicit potent, durable, and protective immunity in nonhuman primates (NHPs) after a single dose. Here, we assessed vaccine immunogenicity following a PARVAX prime-boost regimen against SARS-CoV-2. In mice, a low-dose prime followed by a higher-dose boost elicited potent neutralizing antibody responses and distinct cross-reactivity profiles, depending on the antigen used in the booster vaccine. However, the potent neutralizing anti-vector antibody responses developed in mice limited the dose that could be administered as a prime. We further explored the re-administration efficacy in NHPs primed with a SARS-CoV-2 Delta vaccine and boosted with an Omicron BA.1 vaccine at week 15, after the primary response peak antibody levels were reached. The boost elicited an increase in antibodies against several Omicron variants, but no increase was detected in the antibody titers for other variants. The anti-vector responses were low and showed some increased subsequent boosts but generally declined over time. The potent prime vaccination limited the detection of the boosting effect, and therefore, the effect of anti-vector immunity was not fully elucidated. These data show that PARVAX can be effectively re-administered and induce a novel antigenic response. [ABSTRACT FROM AUTHOR]

To contribute to a better understanding of the determinants of climate-friendly organizational behavior, we study the potential of behavioral policy interventions and social norms to foster individual contributions to organizational decarbonization initiatives. We investigate the effects of different types of behavioral policy interventions (default nudges vs. short-term boosts) in isolation and when they are combined with normative appeals to adopt climate-friendly behaviors in an organizational context. In a 2 × 2 between-subjects experiment, we find that default nudges generally induced higher individual contributions to organizational carbon compensation programs than short-term boosts. Moreover, injunctive social norm information decreased the effectiveness of both types of behavioral interventions but affected the effectiveness of short-term boosts to a stronger extent than the effectiveness of default nudges. Contributing to the nascent literature on motivating climate change mitigating behaviors in organizational contexts, we additionally explore whether factors such as personality traits, pro-social and pro-environmental beliefs, attitudes, and behaviors, and the degree of organizational identification exert an influence on the effectiveness of the interventions and provide qualitative insights into participants' reasoning for their decisions. [ABSTRACT FROM AUTHOR]

Currently, artificial intelligence (AI) is emerging as a dominant force in various technologies, owing to its unparalleled efficiency. Among the plethora of AI techniques available, neural networks (NNs) have garnered significant attention due to their adeptness in addressing diverse challenges, particularly for prediction tasks. This study offers a comprehensive review of predominant AI-based approaches to photovoltaic (PV) energy forecasting, with a particular emphasis on artificial neural networks (ANNs). We introduce a revolutionary methodology that amalgamates the predictive capabilities of ANN with the precision control afforded by the minimum-risk problem and sliding mode control (MRP-SMC), thereby revolutionizing the PV panel performance enhancement. Building upon this methodology, our hybrid approach utilizes the ANN as a proficient weather forecaster, accurately predicting the temperature and solar radiation levels impacting the panels. These forecasts serve as guiding principles for the MRP-SMC algorithm, enabling the proactive determination of the Maximum Power Point (MPP). Unlike conventional methods that grapple with weather unpredictability, the MRP-SMC algorithm transforms stochastic optimization challenges into controllable deterministic risk problems. Our method regulates the boost converter's work cycle dynamically. This dynamic adaptation, guided by environmental predictions from ANNs, unlocks the full potential of PV panels, maximizing energy recovery efficiency. To train the model, we utilized a large dataset comprising 60,538 temperature and solar radiation readings from the Department of Systems Engineering and Automation at the Faculty of Engineering in Vitoria (University of the Basque Country). Our approach demonstrates a high regression coefficient (R = 0.99) and low mean square error (MSE = 0.0044), underscoring its exceptional ability to predict real energy values. In essence, this study proposes a potent fusion of artificial intelligence and control mechanisms that unleash the untapped potential of photovoltaic panels. By utilizing forecasts to guide the converter, we are paving the way for a future where solar energy shines brighter than ever. [ABSTRACT FROM AUTHOR]

Introduction A surge of human influenza A(H7N9) cases began in 2016 in China from an antigenically distinct lineage. Data are needed about the safety and immunogenicity of 2013 and 2017 A(H7N9) inactivated influenza vaccines (IIVs) and the effects of AS03 adjuvant, prime-boost interval, and priming effects of 2013 and 2017 A(H7N9) IIVs. Methods Healthy adults (n = 180), ages 19–50 years, were enrolled into this partially blinded, randomized, multicenter phase 2 clinical trial. Participants were randomly assigned to 1 of 6 vaccination groups evaluating homologous versus heterologous prime-boost strategies with 2 different boost intervals (21 vs 120 days) and 2 dosages (3.75 or 15 μg of hemagglutinin) administered with or without AS03 adjuvant. Reactogenicity, safety, and immunogenicity measured by hemagglutination inhibition and neutralizing antibody titers were assessed. Results Two doses of A(H7N9) IIV were well tolerated, and no safety issues were identified. Although most participants had injection site and systemic reactogenicity, these symptoms were mostly mild to moderate in severity; injection site reactogenicity was greater in vaccination groups receiving adjuvant. Immune responses were greater after an adjuvanted second dose, and with a longer interval between prime and boost. The highest hemagglutination inhibition geometric mean titer (95% confidence interval) observed against the 2017 A(H7N9) strain was 133.4 (83.6–212.6) among participants who received homologous, adjuvanted 3.75 µg + AS03/2017 doses with delayed boost interval. Conclusions Administering AS03 adjuvant with the second H7N9 IIV dose and extending the boost interval to 4 months resulted in higher peak antibody responses. These observations can broadly inform strategic approaches for pandemic preparedness. Clinical Trials Registration. NCT03589807. [ABSTRACT FROM AUTHOR]

This paper proposed a single-stage AC-DC converter based on boost circuit and CLCL-T resonant converter for improving the performance of the LED driver. In practice, the two-stage LED driver is not suitable for low-power lighting applications. To overcome the problems, by integrating the boost power factor correction (PFC) circuit and CLCL-T resonant DC–DC converter, the proposed LED driver exhibits high efficiency and high reliability. The CLCL-T resonant converter can achieve soft-switching on the power switch and rectifier diode and reduce the switch losses at high frequencies. Operation principle, performance analysis and design considerations for the proposed LED driver are analyzed and discussed. The results indicate that the proposed single-stage LED driver is superior in terms of efficiency, volume and number of components. Finally, a 100-W experimental prototype is implemented, and the experimental results verify the effectiveness and feasibility of the proposed LED driver. [ABSTRACT FROM AUTHOR]

Simple Summary: This multicenter study (n = 1133, inclusion criteria: 3.5 cm maximum tumor size and preoperative indication for a boost) provides detailed data on acute and long-term toxicities in breast cancer patients undergoing breast-conserving surgery combined with an anticipated intraoperative boost with low-energy X-rays followed by whole breast irradiation. Toxicity assessments, based on LENT SOMA criteria, were performed annually up to 10 years of follow-up. IORT boost was completed in 90% and EBRT in 97% of cases. No grade 3 or 4 acute toxicities were observed, with mild acute side effects reported in a small proportion of patients. Chronic toxicities were seen in 16.2% of patients with teleangiectasia, 14.3% with grade ≥ 2 fibrosis, 3.4% with grade ≥ 2 pain, and 1.1% with hyperpigmentation. The results show that the therapy is safe and feasible in terms of toxicity and confirms intraoperative boost as a standard method of boost application in a large prospective cohort. In the context of breast cancer treatment optimization, this study prospectively examines the feasibility and outcomes of utilizing intraoperative radiotherapy (IORT) as a boost in combination with standard external beam radiotherapy (EBRT) for high-risk patients. Different guidelines recommend such a tumor bed boost in addition to whole breast irradiation with EBRT for patients with risk factors for local breast cancer recurrence. The TARGIT BQR (NCT01440010) is a prospective, multicenter registry study aimed at ensuring the quality of clinical outcomes. It provides, for the first time, data from a large cohort with a detailed assessment of acute and long-term toxicity following an IORT boost using low-energy X-rays. Inclusion criteria encompassed tumors up to 3.5 cm in size and preoperative indications for a boost. The IORT boost, administered immediately after tumor resection, delivered a single dose of 20 Gy. EBRT and systemic therapy adhered to local tumor board recommendations. Follow-up for toxicity assessment (LENT SOMA criteria: fibrosis, teleangiectasia, retraction, pain, breast edema, lymphedema, hyperpigmentation, ulceration) took place before surgery, 6 weeks to 90 days after EBRT, 6 months after IORT, and then annually using standardized case report forms (CRFs). Between 2011 and 2020, 1133 patients from 10 centers were preoperatively enrolled. The planned IORT boost was conducted in 90%, and EBRT in 97% of cases. Median follow-up was 32 months (range 1–120, 20.4% dropped out), with a median age of 61 years (range 30–90). No acute grade 3 or 4 toxicities were observed. Acute side effects included erythema grade 1 or 2 in 4.4%, palpable seroma in 9.1%, punctured seroma in 0.3%, and wound healing disorders in 2.1%. Overall, chronic teleangiectasia of any grade occurred in 16.2%, fibrosis grade ≥ 2 in 14.3%, pain grade ≥ 2 in 3.4%, and hyperpigmentation in 1.1%. In conclusion, a tumor bed boost through IORT using low-energy X-rays is a swift and feasible method that demonstrates low rates in terms of acute or long-term toxicity profiles in combination with whole breast irradiation. [ABSTRACT FROM AUTHOR]

Purpose: Concurrent chemoradiation is the standard of care for the treatment of anal cancer. Radiation can be delivered by sequential or simultaneous integrated boost (SIB) approach. The present study was conducted to compare the treatment outcomes and toxicity profile of patients with anal cancer treated with sequential boost and SIB approach. Methods: A single-institution retrospective analysis of patients with squamous cell carcinoma of the anal canal treated between 2019 and 2022 with radical chemoradiation was performed. The sequential boost schedule consisted of 45 Gy in 25 fractions (1.8 Gy daily) to the gross tumor, nodes, and elective nodal volume, followed by a 9 Gy in five fractions boost to the gross disease. Patients receiving SIB were treated as per RTOG 0529 protocol. In both the groups, patients were treated with volumetric modulated arc therapy (VMAT). The two groups were compared in terms of overall survival (OS), colostomy-free survival (CFS), relapse-free survival (RFS), and acute toxicity profile. p-values < 0.05 were considered statistically significant. Results: The patient and disease characteristics in both treatment arms were comparable. The only difference was a significantly longer overall treatment time of ≥ 50 days in the sequential arm (77.8% vs 43.8%, p = 0.04). The median follow-up was 18 months. The 2-year CFS was 80% in sequential vs 87.5% at 2 years for the SIB arm, 2-year OS 83.3% vs 58.6%, and 2-year RFS was 38.9% vs 41.7%, respectively. A total of 14 (77.8%) in sequential and 8 (50%) in the SIB arm had disease relapse. On univariate analysis, the involved pelvic lymph node significantly affected OS (HR 10.45, p = 0.03) while inguinal lymph node involvement adversely affected RFS (HR 6.16, p = 0.02). The most common acute toxicity was radiation-induced dermatitis, 15 (83.4%; 5 grade II, 10 grade III) in sequential vs 7 (43.8%; 3 each grade II and III) in the SIB group followed by hematological (61.1% vs 68.75%). However, the incidence of overall acute toxicities was significantly less in the SIB arm (p = 0.006). Conclusion: Our study showed that concurrent chemoradiation with the SIB-VMAT approach is well tolerated in patients of anal carcinoma and resulted in lesser treatment interruptions and comparable outcomes as compared to the sequential approach. Our results warrant further evaluation in a prospective study. [ABSTRACT FROM AUTHOR]

The addition of a boost to the lumpectomy bed after whole-breast (WB) radiotherapy plays a key role in the treatment of patients with breast cancer (BC). The clinical benefits of a boost with high-dose-rate brachytherapy (HDR-BT) after conventional fractionation is supported by a large body of evidence. However, few studies have described its outcomes after a hypofractionated scheme. We included all patients treated with adjuvant WB-IMRT in 15 sessions followed by a single-session HDR-BT boost with local anesthesia on an outpatient basis. Between 2009 and 2017, 638 patients with early-stage BC were treated according to the aforementioned protocol after breast-conserving surgery. Median follow-up was 6 years (4–11). Despite the low incidence of side effects and their slightness, we did identify an impact of breast volume on the risk of acute radiodermatitis, fibrosis, pain and edema. However, we did not identify any relationship between the volume in cubic centimeters of the BT-implant with acute or long-term side effects. 2.2% patients had an actual local relapse, 2.4% a 2nd primary in the same breast and 2.39% were diagnosed with contralateral BC. Event-free survival at 11 years was 85.5% with an overall survival of 95.7%. Adjuvant hypofractionated whole-breast IMRT followed by a single dose HDR-BT boost has a low incidence of acute and chronic toxicity and excellent oncological outcomes. However, it may be worthwhile to intensify self-care protocols and surveillance in women with large breasts who may be at increased risk of side effects. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study is to identify pre- and intraoperative factors indicating the feasibility of intraoperative radiotherapy (IORT) during breast-conserving surgery (BCS). Materials and methods: From January 2018 to December 2019, a total of 128 women undergoing BCS due to early breast cancer were included in this prospective observational study, independent of whether IORT was planned or not. Patient and tumor characteristics as well as surgical parameters that could potentially influence the feasibility of IORT were recorded for the entire collective. In addition, a preoperative senological assessment was performed and analyzed to assess the feasibility of IORT. Logistic regression was then used to identify relevant preoperative parameters and to generate a formula predicting the feasibility of IORT. Results: Of the 128 included women undergoing BCS, 46 were preoperatively rated to be feasible, 20 to be questionably feasible for IORT. Ultimately, IORT was realized in 30 patients. The most frequent reasons for omission of IORT were insufficient tumor-to-skin distance and/or an excessively large tumor cavity. Small clinical tumor size and large tumor-to-skin distance according to preoperative ultrasound were significantly related to accomplishment of IORT. Conclusion: We observed that preoperative ultrasound-based tumor–skin distance is a significant factor in addition to already known parameters to predict feasibility of IORT. Based on our findings we developed a formula to optimize IORT planning which might serve as an additional tool to improve patient selection for IORT in early breast cancer. [ABSTRACT FROM AUTHOR]

Simple Summary: The aim of the present study is to assess, for the first time, the feasibility and safety of combining photon IORT with ultrahypofractionated WBI after breast-conserving surgery (BCS). From July 2020 to December 2022, seventy-two patients diagnosed with low-risk early BC were included in this prospective study. IORT was administered at a dose of 20 Gy to the surface's applicator, and WBI was to be administered 3–5 weeks after surgery at a total dose of 26 Gy in five consecutive days. All patients completed the proposed treatment schedule, and no severe acute or late grade 3 toxicity was observed at 3 and 12 months after WBI, respectively. Our results confirm, for the first time, that the combination of ultrafractionation WBI after BCS and photon-IORT is a feasible and safe option in patients with early BC. Background: The current standard of local treatment for patients with localized breast cancer (BC) includes whole breast irradiation (WBI) after breast-conserving surgery (BCS). Ultrahypofractionated WBI schemes (1-week treatment) were shown not to be inferior to the standard WBI. Tumor bed boost using photon intraoperative radiotherapy (IORT) is safe and feasible in combination with standard WBI. The aim of the present study is to assess, for the first time, the feasibility and safety of combining photon IORT with ultrahypofractionated WBI. Methods: Patients diagnosed with low-risk early BC candidates for BCS were included in this prospective study. IORT was administered at a dose of 20 Gy to the surface's applicator, and WBI was administered 3–5 weeks after surgery at a total dose of 26 Gy in five consecutive days. Results: From July 2020 to December 2022, seventy-two patients diagnosed with low-risk early BC and treated in our institution were included in this prospective study. All patients completed the proposed treatment, and no severe acute or late grade 3 toxicity was observed 3 and 12 months after WBI, respectively. Conclusions: Our results confirm for the first time that the combination of ultrafractionation WBI and photon-IORT after BCS is a feasible and safe option in patients with early BC. [ABSTRACT FROM AUTHOR]

Total skin electron beam therapy (TSEBT) in female patients with large or pendulous breasts is usually associated with shaded inframammary folds. In this analysis, 18 patients with cutaneous malignancy and pendulous breasts were irradiated with a radiation bra and five patients received TSEBT without bra. All patients had moderate or severe sagging of the breasts. The median inframammary dose in the radiation bra group was 89% of the prescription dose versus 4% in the group without bra. The usage of the radiation bra enables an adequate radiation dose for the inframammary folds during TSEBT with no additional local irradiation.

Purpose: Modern literature has demonstrated improvements in long-term biochemical outcomes with the use of prophylactic pelvic nodal irradiation followed by a brachytherapy boost in the management of high-risk prostate cancer. However, this comes at the cost of increased treatment-related toxicity. In this study, we explore the outcomes of the largest cohort to date, which uses a stereotactic body radiation therapy (SBRT) boost following pelvic nodal radiation for exclusively high-risk prostate cancer. Methods and materials: A large institutional database was interrogated to identify all patients with high-risk clinical node-negative prostate cancer treated with conventionally fractionated radiotherapy to the pelvis followed by a robotic SBRT boost to the prostate and seminal vesicles. The boost was uniformly delivered over three fractions. Toxicity was measured using the Common Terminology Criteria for Adverse Events (CTCAE) version 5.0. Oncologic outcomes were assessed using the Kaplan--Meier method. Cox proportional hazard models were created to evaluate associations between pretreatment characteristics and clinical outcomes. Results: A total of 440 patients with a median age of 71 years were treated, the majority of whom were diagnosed with a grade group 4 or 5 disease. Pelvic nodal irradiation was delivered at a total dose of 4,500 cGy in 25 fractions, followed by a three-fraction SBRT boost. With an early median follow-up of 2.5 years, the crude incidence of grade 2+ genitourinary (GU) and gastrointestinal (GI) toxicity was 13% and 11%, respectively. Multivariate analysis revealed grade 2+ GU toxicity was associated with older age and a higher American Joint Committee on Cancer (AJCC) stage. Multivariate analysis revealed overall survival was associated with patient age and posttreatment prostate-specific antigen (PSA) nadir. Conclusion: Utilization of an SBRT boost following pelvic nodal irradiation in the treatment of high-risk prostate cancer is oncologically effective with early follow- up and yields minimal high-grade toxicity. We demonstrate a 5-year freedom from biochemical recurrence (FFBCR) of over 83% with correspondingly limited grade 3+ GU and GI toxicity measured at 3.6% and 1.6%, respectively. Long-term follow-up is required to evaluate oncologic outcomes and late toxicity. [ABSTRACT FROM AUTHOR]

Simple Summary: Current guidelines recommend treatment planning using [18F]FDG-PET/CT for the management of advanced cervical cancer, where suspicious lymph nodes may be treated with nodal boosting, extended-field radiotherapy, and/or debulking in addition to standard chemoradiotherapy to improve survival. However, caution must be exercised because of the risk of unnecessary therapy-related toxicity due to the overtreatment of false-positive nodes. Despite this daily dilemma in clinical practice, only a few studies have evaluated the management of [18F]FDG-positive nodes. Therefore, this study aimed to assess how often [18F]FDG-PET/CT lymph node information is used in the management of advanced-stage cervical cancer. We found that a total of 380/434 patients (88%) received interventions targeting [18F]FDG-positive nodes, with the following distribution: nodal boosting (84%), extended-field radiotherapy (78%), and debulking (12%). Despite existing guidelines advocating [18F]FDG-PET/CT-guided treatment planning for the management of advanced cervical cancer, this study highlights that not all cases of [18F]FDG-positive nodes received an intervention. Background: Modern treatment guidelines for women with advanced cervical cancer recommend staging using 2-deoxy-2-[18F]fluoro-D-glucose positron emission computed tomography ([18F]FDG-PET/CT). However, the risk of false-positive nodes and therapy-related adverse events requires caution in treatment planning. Using data from the Netherlands Cancer Registry (NCR), we estimated the impact of [18F]FDG-PET/CT on treatment management in women with locally advanced cervical cancer, i.e., on nodal boosting, field extension, and/or debulking in cases of suspected lymph nodes. Methods: Women diagnosed between 2009 and 2017, who received chemoradiotherapy for International Federation of Gynaecology and Obstetrics (2009) stage IB2, IIA2-IVB cervical cancer with an [18F]FDG-positive node, were retrospectively selected from the NCR database. Patients with pathological nodal examination before treatment were excluded. The frequency of nodal boosting, extended-field radiotherapy, and debulking procedures applied to patients with [18F]FDG-positive lymph nodes was evaluated. Results: Among the 434 eligible patients with [18F]FDG-positive nodes, 380 (88%) received interventions targeting these lymph nodes: 84% of these 380 patients received nodal boosting, 78% extended-field radiotherapy, and 12% debulking surgery. [18F]FDG-positive nodes in patients receiving these treatments were more likely to be classified as suspicious than inconclusive (p = 0.009), located in the para-aortic region (p < 0.001), and larger (p < 0.001) than in patients who did not receive these treatments. Conclusion: While existing guidelines advocate [18F]FDG-PET/CT-guided treatment planning for the management of advanced cervical cancer, this study highlights that not all cases of [18F]FDG-positive nodes received an intervention, possibly due to the risk of false-positive results. Improvement of nodal staging may reduce suboptimal treatment planning. [ABSTRACT FROM AUTHOR]

The raising of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) variants led to the use of COVID‐19 bivalent vaccines, which include antigens of the wild‐type (WT) virus, and of the Omicron strain. In this study, we aimed to evaluate the impact of bivalent vaccination on the neutralizing antibody (NAb) response. We enrolled 93 volunteers who had received three or four doses of monovalent vaccines based on the original virus (n = 61), or a booster shot with the bivalent vaccine (n = 32). Serum samples collected from volunteers were subjected to neutralization assays using the WT SARS‐CoV‐2, and Omicron subvariants. In addition, immunoinformatics to quantify and localize highly conserved NAb epitopes were performed. As main result, we observed that the neutralization titers of samples from individuals vaccinated with the bivalent vaccine were higher for the original virus, in comparison to their capacity of neutralizing the Omicron variant and its subvariants. NAb that recognize epitopes mostly conserved in the WT SARS‐CoV‐2 were boosted, while those that recognize epitopes mostly present in the Omicron variant, and subvariants were primed. These results indicate that formulation of future vaccines shall consider to target present viruses, and not viruses that no longer circulate. [ABSTRACT FROM AUTHOR]

This paper presents the design and application of a boost converter operated in continuous conduction mode for 15 W, with a 25 kHz switching frequency using an inductor-capacitor-inductor (LCL), pi, inductor capacitor (LC) with damping, and LC electromagnetic interference filters. Also, modeling and analysis of the boost converter in terms of state space and small signal are given. Furthermore, the effect of each filter on differential mode (DM) noise and control characteristics is presented using root locus and bode diagrams, which are not detailed in the literature for the boost converter. All results obtained from applications and simulations are compared. Moreover, frequency spectrums are given to compare DM noises. As a result, from a control point of view, the LCL filter provides better results, and for reducing DM noise, the LC and pi filters are superior to others. Besides, the LCL filter reduces the inductor value by 30% compared to other filters. [ABSTRACT FROM AUTHOR]

Purpose: We evaluate various approaches to target volume definition and boost delivery in patients with complete response to neoadjuvant systemic therapy (NST) who were treated by radiotherapy without a surgery. Materials and Methods: A pathological complete response (pCR) was diagnosed in 21 of 27 patients included in "surgery de-escalation" prospective observation study. Clips were placed in the primary tumor volume (PrTV) before NST and during the vacuum aspiration biopsy. Twenty patients with pCR underwent the whole breast irradiation and a boost to the PrTV. High-dose rate brachytherapy (HDRB) was the basic technique for boost delivery. Finally, we identified the value of fused images (computed tomography [CT] before NST with simulation CT), clips and their combination for an accurate boost delivery. Results: A complete overlap between PrTV on pre-treatment CT with the localization of the clips on simulation CT was mentioned in 10, partial mismatch in three patients. In 12 of these 13 women, HDRB was successfully used for the boost delivery. In five cases we mentioned a marked discrepancy between the PrTV on fused images and the topography of the clips. In other two women we did not find clips on simulation CT. The fused images in five of these seven patients showed anatomical landmarks (scar, fibrosis) used for identification of the gross tumor volume. In all 20 women with pCR (average follow-up of 16.6 months), there were no locoregional recurrences. Conclusion: Combination of the clips with fusion of pre-NST and simulation CTs is important for an accurate boost delivery. [ABSTRACT FROM AUTHOR]

DC–DC converters are among the main components of DC power systems based on renewable energy sources. In some applications, interleaved multi-phase converters are employed to reduce the converter input current and output voltage ripples and increase reliability. On the other hand, modular converters are also employed in some applications mainly to increase the system power range, reliability, and reconfigurability. Developing effective methods for controlling and monitoring the modular multi-phase converters plays an important role in the power system's performance and efficiency. In this paper, a new effective Lyapunov-based control method is proposed for the modular multi-phased DC–DC boost converters. The modular converter includes two main multi-phase modules and one reserved module which substitutes the main modules in the fault conditions. The proposed control method is superior to the conventional proportional-integral controller in terms of the response speed and converter's current and voltage transient variations. Also, the proposed controller reduces the number of integrators which leads to the simplified implementation. The validity of the proposed method is confirmed by simulation and experimental results. [ABSTRACT FROM AUTHOR]

This paper demonstrates the performance of a new innovative photovoltaic microinverter topology with high power quality and efficiency. This inverter is based on coupling a boost converter with a discharge circuit to provide a rectified sine wave voltage. In the first part of this paper, we describe the proposed topology and its operating principle as well as the simple and robust control system used. We also verify the stability of the system using the Lyapunov method. In the second part, we present the simulation results and discuss the influence of the load nature on the total harmonic distortion (THD) and on the efficiency. [ABSTRACT FROM AUTHOR]

PARVAX is a genetic vaccine platform based on an adeno-associated vector that has demonstrated to elicit potent, durable, and protective immunity in nonhuman primates (NHPs) after a single dose. Here, we assessed vaccine immunogenicity following a PARVAX prime-boost regimen against SARS-CoV-2. In mice, a low-dose prime followed by a higher-dose boost elicited potent neutralizing antibody responses and distinct cross-reactivity profiles, depending on the antigen used in the booster vaccine. However, the potent neutralizing anti-vector antibody responses developed in mice limited the dose that could be administered as a prime. We further explored the re-administration efficacy in NHPs primed with a SARS-CoV-2 Delta vaccine and boosted with an Omicron BA.1 vaccine at week 15, after the primary response peak antibody levels were reached. The boost elicited an increase in antibodies against several Omicron variants, but no increase was detected in the antibody titers for other variants. The anti-vector responses were low and showed some increased subsequent boosts but generally declined over time. The potent prime vaccination limited the detection of the boosting effect, and therefore, the effect of anti-vector immunity was not fully elucidated. These data show that PARVAX can be effectively re-administered and induce a novel antigenic response.

Currently, artificial intelligence (AI) is emerging as a dominant force in various technologies, owing to its unparalleled efficiency. Among the plethora of AI techniques available, neural networks (NNs) have garnered significant attention due to their adeptness in addressing diverse challenges, particularly for prediction tasks. This study offers a comprehensive review of predominant AI-based approaches to photovoltaic (PV) energy forecasting, with a particular emphasis on artificial neural networks (ANNs). We introduce a revolutionary methodology that amalgamates the predictive capabilities of ANN with the precision control afforded by the minimum-risk problem and sliding mode control (MRP-SMC), thereby revolutionizing the PV panel performance enhancement. Building upon this methodology, our hybrid approach utilizes the ANN as a proficient weather forecaster, accurately predicting the temperature and solar radiation levels impacting the panels. These forecasts serve as guiding principles for the MRP-SMC algorithm, enabling the proactive determination of the Maximum Power Point (MPP). Unlike conventional methods that grapple with weather unpredictability, the MRP-SMC algorithm transforms stochastic optimization challenges into controllable deterministic risk problems. Our method regulates the boost converter’s work cycle dynamically. This dynamic adaptation, guided by environmental predictions from ANNs, unlocks the full potential of PV panels, maximizing energy recovery efficiency. To train the model, we utilized a large dataset comprising 60,538 temperature and solar radiation readings from the Department of Systems Engineering and Automation at the Faculty of Engineering in Vitoria (University of the Basque Country). Our approach demonstrates a high regression coefficient (R = 0.99) and low mean square error (MSE = 0.0044), underscoring its exceptional ability to predict real energy values. In essence, this study proposes a potent fusion of artificial intelligence and control mechanisms that unleash the untapped potential of photovoltaic panels. By utilizing forecasts to guide the converter, we are paving the way for a future where solar energy shines brighter than ever.

Surgical techniques for breast cancer have been refined over the past decades to deliver an aesthetic outcome as close as possible to the contralateral intact breast. Current surgery further allows excellent aesthetic outcome even in case of mastectomy, by performing skin sparing or nipple sparing mastectomy in combination with breast reconstruction. In this review we discuss how to optimise post-operative radiation therapy after oncoplastic and breast reconstructive procedures, including dose, fractionation, volumes, surgical margins, and boost application.

PurposeModern literature has demonstrated improvements in long-term biochemical outcomes with the use of prophylactic pelvic nodal irradiation followed by a brachytherapy boost in the management of high-risk prostate cancer. However, this comes at the cost of increased treatment-related toxicity. In this study, we explore the outcomes of the largest cohort to date, which uses a stereotactic body radiation therapy (SBRT) boost following pelvic nodal radiation for exclusively high-risk prostate cancer.Methods and materialsA large institutional database was interrogated to identify all patients with high-risk clinical node-negative prostate cancer treated with conventionally fractionated radiotherapy to the pelvis followed by a robotic SBRT boost to the prostate and seminal vesicles. The boost was uniformly delivered over three fractions. Toxicity was measured using the Common Terminology Criteria for Adverse Events (CTCAE) version 5.0. Oncologic outcomes were assessed using the Kaplan–Meier method. Cox proportional hazard models were created to evaluate associations between pretreatment characteristics and clinical outcomes.ResultsA total of 440 patients with a median age of 71 years were treated, the majority of whom were diagnosed with a grade group 4 or 5 disease. Pelvic nodal irradiation was delivered at a total dose of 4,500 cGy in 25 fractions, followed by a three-fraction SBRT boost. With an early median follow-up of 2.5 years, the crude incidence of grade 2+ genitourinary (GU) and gastrointestinal (GI) toxicity was 13% and 11%, respectively. Multivariate analysis revealed grade 2+ GU toxicity was associated with older age and a higher American Joint Committee on Cancer (AJCC) stage. Multivariate analysis revealed overall survival was associated with patient age and posttreatment prostate-specific antigen (PSA) nadir.ConclusionUtilization of an SBRT boost following pelvic nodal irradiation in the treatment of high-risk prostate cancer is oncologically effective with early follow-up and yields minimal high-grade toxicity. We demonstrate a 5-year freedom from biochemical recurrence (FFBCR) of over 83% with correspondingly limited grade 3+ GU and GI toxicity measured at 3.6% and 1.6%, respectively. Long-term follow-up is required to evaluate oncologic outcomes and late toxicity.

Breast cancer is the most common malignancy, and the majority of the patients are diagnosed at an early disease stage. Breast conservation is the preferred locoregional approach, and oncoplastic breast conservation surgery is becoming more popular. This narrative review aims to discuss the challenges and uncertainties in target volume definition for postoperative radiation after these procedures, to improve radiation therapy decisions and encourage multidisciplinary.

Background: The standard of care for glioblastoma multiforme (GBM) is maximal surgical resection followed by conventional fractionated concurrent chemoradiotherapy (CCRT) with a total dose of 60 Gy. However, there is currently no consensus on the optimal boost technique for CCRT in GBM. Methods: We conducted a retrospective review of 398 patients treated with CCRT between 2016 and 2021, using data from two institutional databases. Patients were divided into two groups: those receiving sequential boost (SEB, N = 119) and those receiving simultaneous integrated boost (SIB, N = 279). The primary endpoint was overall survival (OS). To minimize differences between the SIB and SEB groups, we conducted propensity score matching (PSM) analysis. Results: The median follow-up period was 18.6 months. Before PSM, SEB showed better OS compared to SIB (2-year, 55.6% vs. 44.5%, p = 0.014). However, after PSM, there was no significant difference between two groups (2-year, 55.6% vs. 51.5%, p = 0.300). The boost sequence was not associated with inferior OS before and after PSM (all p-values > 0.05). Additionally, the rates of symptomatic pseudo-progression were similar between the two groups (odds ratio: 1.75, p = 0.055). Conclusions: This study found no significant difference in OS between SEB and SIB for GBM patients treated with CCRT. Further research is needed to validate these findings and to determine the optimal boost techniques for this patient population. [ABSTRACT FROM AUTHOR]

A single-phase bidirectional DC/DC battery charger with a P&O MPPT current control strategy for a standalone energy management system has been integrated with an interleaved switched capacitor DC/AC inverter with an RMS feedback phase-shifted unipolar sinusoidal PWM control strategy. In the published literature, P&O MPPT control is used to drive a boost converter connected in parallel to a battery charger; this modified strategy combines a P&O MPPT algorithm with current control to drive an interleaving buck-boost battery charger. This battery charger circuit is connected in parallel to a closed loop controlled interleaved inverter that feeds the AC home load. MATLAB/Simulink based simulation circuit was developed and used to validate the successful integration of the interleaved battery charger with the global system. To do this, the system is tested with varying input conditions of irradiance and temperature. The system's response to these variable inputs is monitored and analysed. The simulation results show the proposed method is effective for standalone battery-based PV systems. The system provides a more efficient and faster response compared with both an interleaved and non-interleaved voltage-controlled battery charger circuit that is also integrated with the global system. This battery charger control strategy is also shown to protect the battery from over-charging as well as discharging below 25%, which can improve and protect the long-term battery performance. Compared with novel industry approaches, the proposed system is simpler by nature due to the reduced number of conversions and therefore a reduced number of components which provides economic advantages. [ABSTRACT FROM AUTHOR]

The design and development of a non-isolated buck-based three-port dc–dc converter for medium-power standalone PV systems are presented in this paper. The topology is obtained from a parallel connection of conventional buck and boost converters. An attractive feature of this converter is the implementation of a buck topology at the PV side, which ensures cost-effective PV panel wiring, reduced converter development cost, and better efficiency of the PV system during low irradiation periods when compared to its boost counterpart. The proposed converter includes three operating modes based on load power requirements and PV power generation. An autonomous mode transition algorithm is proposed for seamless transitions between various operating modes. The design methodology, losses, and operation of the converter are discussed in this paper. A low-cost and efficient 2 kW laboratory prototype model of the proposed converter has been developed. Experimental validations are provided to showcase the effectiveness and viability of the proposed converter under various operating conditions. [ABSTRACT FROM AUTHOR]

The optimal treatment of metastatic lymph nodes (LNs) in locally-advanced cervical cancer (LACC) is controversial. With the widespread use of modern radiotherapy (RT) techniques, it is become possible to perform dose escalation in clinically involved LNs. This study aimed to evaluate the oncologic outcomes of dose escalation to the involved LNs with the simultaneous-integrated (SIB) or sequential boost (SEB) techniques as a part of definitive chemoradiotherapy (CRT) for patients with LACC. The data of 47 patients treated with definitive CRT with either a SIB or SEB technique to the metastatic LNs between 2015 and 2021 were retrospectively analyzed. All patients received 50.4 Gy/28 fractions of external-beam RT and 28 Gy/4 fractions of brachytherapy. The number of boosted LNs was 146. The median size of the LNs was 2 cm (range, 1–5 cm). The median cumulative equivalent dose in 2-Gy fractions for the LNs was 64.2 Gy (range, 57.6–71.2 Gy). During the median 30 months of follow-up (range, 14–91 months), no boosted LNs recurred and the local control (LC) rate was 100%. The 2-year overall, disease-free, local recurrence-free, and distant metastasis-free survival rate was 83.1%, 70.5%, 77.5%, and 74.4%, respectively. In multivariate analysis, the non-squamous cell histology was the only negative independent prognostic factor for DFS and DMFS. Treatment was well tolerated without any serious acute toxicity. Serious late toxicity developed in three (6%) patients as ureteral stenosis, rectal bleeding and pelvic fracture in one patient each. RT dose escalation provides excellent LC for the clinically involved LNs, even for bulky ones, with a low toxicity profile. Routine LN dissection may not be necessary. However, randomized trials are needed to determine the optimal treatment approach. • Dose escalation to the clinically involved lymph nodes by modern radiotherapy techniques provides excellent nodal control. • Combined use of simultaneous integrated and sequential boost techniques is feasible. • The dose contribution of brachytherapy should be kept in mind prior to additional dose prescription to the lymph nodes. [ABSTRACT FROM AUTHOR]

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This study aims to determine how the global media covered the Padma Bridge inauguration news and its contribution to achieving the SDGs (Sustainable Development Goals) of Bangladesh. After overcoming several obstacles, Bengalis’ desire to use their own money is set to become a reality. In this study, both qualitative and quantitative methods were used. The first stage was using convenience the sampling method to gather information on the Padma Multipurpose Bridge’s opening, from 25 June to 25 July 2022, from the usual worldwide media and TV networks. The information coverage of several news sources from various countries was subsequently investigated utilizing the content analysis approach. In one way, newspaper stories, expert comments, research papers on the Padma Bridge, government reports, the Bangladesh Planning commission, and finance ministry records have all been analysed to collect the Padma Bridge’s role in fulfilling SDGs. The data show that the Padma Bridge, which showcases Bangladesh’s financial potential, is given significant weight in the international media. The Padma Bridge will contribute to a 29% increase in Bangladesh’s development industry, a 9.5% increase in agricultural output, an 8% increase in the industrial and transportation sectors, and a 0.84% annual decrease in poverty. By the year 2041, Bangladesh hopes to be a prosperous, ecologically friendly, and socially inclusive monarchy. The Padma Bridge will facilitate the development of new rail networks, improve connectivity, and expand global trade. Through this bridge, the enhancement of people’s lifestyles and subsistence abilities is made possible in a significant way.

Background: As part of a breast-conservation strategy for breast cancer, there are presently no data from randomized controlled studies on the use of intraoperative radiation (IORT) as a tumor bed boost. The effectiveness and safety of IORT as a boost therapy at a tertiary cancer center were retrospectively reviewed in this study. Methods: Patients had breast-conserving surgery from 2012 to 2016 that included staging of the axillary lymph nodes, a single dose of 20 Gy IORT with 50-kV photons, whole-breast irradiation (WBI), and (neo-)adjuvant systemic treatment (if applicable). During the follow-up patients were monitored for the assessment of acute and late toxicities (using the Common Terminology Criteria for Adverse Events version 4.03). Results included ipsilateral (IBTR), contralateral (CBE), and distant metastasis-free (DMFS) breast progression-free survival, as well as overall survival (OS). Results: The 68 patients had a median follow-up of 91.5 months (with a range of 9–125). Most patients (n = 51) had T1 disease and were clinically node negative. Only a small number of individuals had triple negative or high-grade illness. The majority of patients had sentinel node biopsy, and three (4.4%) had to have their tumors removed again since their original margins were positive. Finally, there were no distinct tumor bed margins. Neoadjuvant chemotherapy was administered to ten (14.7%). The median duration from BCS to WBI was 54.5 days, and conventionally fractionated WBI was used to accomplish WBI most frequently (n = 57, 96.6%). IORT was administered in a single 20 Gy dosage. 50 Gy was the median WBI dosage (range 40.05–50.4 Gy). There were no grade 4 adverse events for any patients in. Toxicities following surgery were minimal. There were only one patient with grade 3 toxicity (radiation dermatitis) to observe. Five tumor bed recurrences and two contralateral breast incident each occurred. Conclusion: This work adds to the preliminary evidence already in the literature and supports the use of IORT in boost settings. When randomized trials like TARGIT-B are eventually published, these hopeful findings should be prospectively evaluated. [ABSTRACT FROM AUTHOR]

To analyze clinical outcomes of high-dose-rate (HDR) interstitial brachytherapy boost (ISBT) after external beam radiation therapy (EBRT) or chemoradiotherapy (CRT) for the treatment of anal canal cancers (ACC). A total of 78 patients with ACC were treated at our institution by ISBT. Local Control (LC), disease-free survival (DFS), overall survival (OS), colostomy-free survival (CFS) and toxicity rates were analyzed. With a median followup (FU) of 59.8 months (95% CI [55.8–64.2]), six (7.7%) local recurrences with 2 patients (2.6%) having persistent disease at 3 months were observed. The 5-year rate of LC for the entire population was 92% [83–96%]. The 5-year DFS rate was 86% [76–93%]. The 5-year OS was 96% [88–99%]. In the univariate analysis, chemotherapy was significantly associated with morbidity grade ≥2. Late digestive toxicity grade ≥3 was reported in 8.9% patients, 1 patient underwent colostomy due to toxicity. The 5-year CFS rate was 88% [79–94%]. HDR interstitial brachytherapy boost provide excellent rates of tumor control and colostomy-free survival with a favorable profile of GI toxicity. Continence in anal cancer survivors is a challenge and the boost technique must be discussed in a multidisciplinary approach as part of de-escalation treatments. [ABSTRACT FROM AUTHOR]

In this paper, an attempt is made to build an effective solar photovoltaic (PV) system considering geographical aspects such as irradiance and temperature using the single-diode equation model. Furthermore, a comparative analysis of various DC-DC converters (buck, boost, inverting buck-boost, non-inverting buck-boost (NIBB), Cuk, and single-ended primary inductance converter (SEPIC)) connected to a solar photovoltaic (PV) module was conducted in order to determine the optimal combination of DC-DC converter and solar PV. Moreover, the R, L, and C parameters for the converters have also been proposed to gain optimum efficiency from the solar PV system, and it has been shown that increasing the resistance decreases the ripple value. Furthermore, it has been shown that Ns and Np values of 36 and 1, respectively, result in 199 W of output power from a solar PV module at the maximum power point (48 V). The obtained results show that NIBB and SEPIC simulations gave the best results, with efficiencies of 93.27% and 92.35%, respectively. [ABSTRACT FROM AUTHOR]