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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]

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.

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.

This paper presents a simple 3 level DC-DC boost converter for fuel cell applications to boost voltage from 48 V DC to 210 V DC. The main advantages of this converter are its simple design, presence of a single switching element for easy controllability, compact size, low cost and high power density. It is basically a simple boost converter with 3 stage voltage multiplier connected to the output side. Simulation and Hardware results for a power level of 250 W are provided in this paper.

This study investigated the short-term and long-term impact of nudging and boosting within an environmental education program on students' environmental attitudes and energy-saving actions. We conducted a randomized assignment across primary and junior high schools, employing four study settings: board game-based environmental education without nudges or boosts (control); with nudges (setting energy-saving goals in a reflection session); with boosts (a game with a "tragedy of the commons" setting); and with both nudges and boosts. In the game with the "tragedy of the commons" setting, the specification was that pursuing self-interest would harm those of the entire group as well as one's own interests; the aim was to enhance environmental literacy by conveying the importance of cooperation through information. We found that students subjected to the boost became significantly more environmentally conscious in the game and set more goals in the goal-setting nudge task. A follow-up survey was conducted one- and three-months post-intervention. This revealed that students in the nudge-and-boost group, who set higher goals, displayed increased awareness of energy conservation, improved environmental attitudes, and greater adoption of energy-saving practices relative to the control group. The results suggest that combining nudges with boosts sustains the long-term effects of environmental education. • Field experiment conducted on environmental education. • Nudge treatment setting goals for energy-saving actions. • Boost treatment playing a game with "the tragedy of the commons" setting. • Students in the nudge-and-boost group exhibited greater energy-saving awareness. • These students developed energy-saving actions after one month of education. • Effects of the environmental education persisted three months later. [ABSTRACT FROM AUTHOR]

Objective: The objective was to evaluate the safety and efficacy of ultra-rapid-acting insulin with the Boost and Ease-off features of the Cambridge hybrid closed-loop system., Methods: A secondary analysis of Boost and Ease-off from two double-blind, randomized, crossover hybrid closed-loop studies comparing (1) Fiasp to insulin aspart (n = 25), and (2) Lyumjev to insulin lispro (n = 26) was carried out. Mean glucose on initialization of Boost and Ease-off, change in glucose 60 and 120 minutes after initialization, duration and frequency of use, mean glucose, and time in, above, and below target glucose range were calculated for periods of Boost use, Ease-off use, or neither., Results: Participants used Boost for longer with Fiasp than insulin aspart (median [interquartile range, IQR] = 75 [53-125] minutes vs 60 [49-75] minutes; P = .01). Mean glucose on Boost initialization with Fiasp was 238 ± 62 mg/dL compared with 218 ± 45 mg/dL with insulin aspart ( P = .08). Fiasp use resulted in a greater glucose reduction 120 minutes after Boost initialization [-59 ± 34 mg/dL vs -43 ± 31 mg/dL; P = .02]. There were no statistically significant differences in sensor glucose endpoints during Boost or Ease-off periods between Fiasp and aspart. There were no statistically significant differences during Boost or Ease-off periods when comparing Lyumjev with insulin lispro. There were no safety issues when using Boost and Ease-off with ultra-rapid insulins., Conclusions: The use of Fiasp and Lyumjev during Boost or Ease-off resulted in comparable safety and efficacy to using insulin aspart and lispro., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: CB is a consultant at CamDiab and has received speaker honoraria from Ypsomed. MN has received travel grant support from Sanofi, Janssen, and Eli Lilly and was previously chair of the Young Diabetologists’ and Endocrinologists’ Forum in the United Kingdom, which uses unrestricted sponsorship from industry partners to deliver educational programs for health care professionals. SH serves as a member of Medtronic advisory board, is a director of Ask Diabetes Ltd, providing training and research support in health care settings, and reports having received training honoraria from Medtronic and Sanofi and consulting fees for CamDiab. MEW is a consultant to CamDiab and reports patents related to closed loop. JW has received speaker honoraria from Ypsomed and Novo Nordisk. HT receives consulting fees and speaker honoraria from Eli Lilly and Dexcom Inc, reports having received research support from Dexcom Inc, and participated in advisory groups for Medtronic, Abbott Diabetes Care, and Roche Diabetes Care. JKM is a member in the advisory boards of Abbott Diabetes Care, Becton-Dickinson/Embecta, Biomea, Eli Lilly, Medtronic, Novo Nordisk, Pharmasens, Roche Diabetes Care, Sanofi, and Viatris; received speaker honoraria from Abbott Diabetes Care, A. Menarini Diagnostics, Becton-Dickinson/Embecta, Boehringer-Ingelheim, Eli Lilly, MedTrust, Novo Nordisk, Roche Diabetes Care, Sanofi, and Ypsomed; and is shareholder of decide Clinical Software GmbH and elyte Diagnostics. LB reports having participated in advisory boards of Eli Lilly, Novo Nordisk, Oviva, Roche Diabetes Care, Sanofi, and Ypsomed and received speaker fees from Dexcom, Ypsomed, and Oviva. LL has received research support from Abbott Diabetes Care and Dexcom, participated in advisory groups for Abbott Diabetes Care, Insulet, Dexcom, Medtronic, and Roche Diabetes, and received fees for speaking from Sanofi, Insulet, Medtronic, and Abbott Diabetes Care. MLE has been a member of advisory panels and/or received speaker fees from Novo Nordisk, Eli Lilly, Sanofi, Abbott Diabetes Care, Dexcom, Medtronic, Ypsomed, Pila Pharma, and Zucara. RH reports having received speaker honoraria from Eli Lilly, Dexcom, and Novo Nordisk; receiving license fees from B. Braun; patents related to closed-loop; being consultant to Abbott Diabetes Care; and being director at CamDiab. CR, RL, and JMA report no conflicts of interest related to the present paper.

Background and Objective: Despite the high efficacy of high-dose-rate brachytherapy boost (HDRB) in the management of prostate cancer (PC), use of this approach is declining. Similar dosimetry can be achieved using stereotactic body radiotherapy or "virtual HDRB" (vHDRB). The aim of the multicentre, single-arm, phase 2 PROMETHEUS trial (ACTRN12615000223538) was to evaluate the safety and efficacy of vHDRB in patients with PC., Methods: Patients with intermediate-risk PC or selected patients with high-risk PC were eligible for inclusion. vHDRB was given as 19-20 Gy in two fractions, delivered 1 wk apart, followed by conventionally fractionated external beam radiotherapy (EBRT) at 46 Gy in 23 fractions or 36 Gy in 12 fractions. The primary endpoint was the biochemical/clinical relapse-free rate (bcRFR). Toxicity was graded using Common Terminology Criteria for Adverse Events version 4 and quality of life (QoL) data were collected used the Expanded Prostate Cancer Index Composite-26 questionnaire., Key Findings and Limitations: From March 2014 to December 2018, 151 patients (74% intermediate risk, 26% high risk) with a median age of 69 yr were treated across five centres. Median follow-up was 60 mo. The 5-yr bcRFR was 94.1% (95% confidence interval [CI] 90-98%) and the local control rate was 98.7%. Acute grade 2 gastrointestinal (GI) and genitourinary (GU) toxicity occurred in 6.6% and 23.2% of patients, respectively, with no acute grade 3 toxicity. At 60 mo after treatment, the prevalence of late grade ≥2 GI toxicity was 1.7% (95% CI 0.3-6.5%) and the prevalence of late grade ≥2 GU toxicity was 3.3% (95% CI 1.1-8.8%). Between baseline and 60 mo, QoL improved for urinary obstructive and hormonal domains, was stable for the bowel domain, and deteriorated slightly for the sexual and urinary incontinence domains., Conclusions: Delivery of gantry-based vHDRB followed by conventionally fractionated EBRT is feasible in a multicentre setting, with high 5-yr bcRFR and low toxicity. This approach is being compared with prostate ultrahypofractionated radiotherapy in the TROG 18.01 NINJA randomised trial (ACTRN12618001806257)., Patient Summary: The PROMETHEUS trial investigated noninvasive high-dose precision radiotherapy combined with conventional radiotherapy in patients with prostate cancer. We found that this new technique was well tolerated and resulted in better cancer control outcomes than historically reported., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

The usage and safety of the Boost and Ease-off features in the CamAPS FX hybrid closed-loop system were analyzed in a retrospective analysis of real-world data from 7,464 users over a 12-month period. Boost was used more frequently than Ease-off, but for a shorter duration per use. Mean starting glucose was above range for Boost (229 ± 51 mg/dL), and within range for Ease-off (114 ± 29 mg/dL). Time spent below 70 mg/dL was low during Boost periods [median (interquartile range; IQR) 0.0% (0.0, 0.5%)], and lower than during no Boost periods [2.1% (1.2, 3.4%)], while time spent above 180 mg/dL was lower during Ease-off periods (15 ± 14%) compared with no Ease-off periods (25 ± 12%). There were no episodes of severe hypoglycemia or diabetic ketoacidosis attributed to Boost or Ease-off use. Boost and Ease-off allow users to engage safely with CamAPS FX to manage their glucose levels during periods of more-than-usual and less-than-usual insulin needs.

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., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Author(s).)

Sequencing the tyrosine phosphoproteome using MS-based proteomics is challenging due to the low abundance of tyrosine phosphorylation in cells, a challenge compounded in scarce samples like primary cells or clinical samples. The broad-spectrum optimisation of selective triggering (BOOST) method was recently developed to increase phosphotyrosine sequencing in low protein input samples by leveraging tandem mass tags (TMT), phosphotyrosine enrichment, and a phosphotyrosine-loaded carrier channel. Here, we demonstrate the viability of BOOST in T cell receptor (TCR)-stimulated primary murine T cells by benchmarking the accuracy and precision of the BOOST method and discerning significant alterations in the phosphoproteome associated with receptor stimulation. Using 1 mg of protein input (about 20 million cells) and BOOST, we identify and precisely quantify more than 2000 unique pY sites compared to about 300 unique pY sites in non-BOOST control samples. We show that although replicate variation increases when using the BOOST method, BOOST does not jeopardise quantitative precision or the ability to determine statistical significance for peptides measured in triplicate. Many pY previously uncharacterised sites on important T cell signalling proteins are quantified using BOOST, and we identify new TCR responsive pY sites observable only with BOOST. Finally, we determine that the phase-spectrum deconvolution method on Orbitrap instruments can impair pY quantitation in BOOST experiments., (© 2024 Wiley‐VCH GmbH.)

We aimed to assess disease-free survival (DFS), overall survival (OS) and treatment-related toxicity of two therapeutic strategies for treating bulky lymph nodes on imaging in patients with locally advanced cervical cancer (LACC): radiotherapy boost versus surgical debulking followed by radiotherapy. We performed a systematic review of studies published up to October 2023. We selected studies including patients with LACC treated by external beam radiotherapy (EBRT) boost or lymph node debulking followed by EBRT (with or without boost). We included two comparative (included in the meta-analysis) and nine non-comparative studies. The estimated 3-year recurrence rate was 28.2% (95%CI:18.3–38.0) in the EBRT group and 39.9% (95%CI:22.1–57.6) in the surgical debulking plus EBRT group. The estimated 3-year DFS was 71.8% and 60.1%, respectively (p = 0.19). The estimated 3-year death rate was 22.2% (95%CI:11.2–33.2) in the EBRT boost group and 31.9% (95%CI:23.3–40.5) in the surgical debulking plus EBRT group. The estimated 3-year OS was 77.8% and 68.1%, respectively (p = 0.04). No difference in lymph node recurrence between the two comparative studies (p = 0.36). The meta-analysis of the two comparative studies showed no DFS difference (p = 0.13) but better OS in the radiotherapy boost group (p = 0.006). The incidence of grade≥3 toxicities (ranging 0–50%) was not different between the two approaches in the two comparative studies (p = 0.31). No DFS and toxicity difference when comparing EBRT boost with surgical debulking of enlarged lymph nodes and EBRT in patients with cervical cancer was evident. Radiotherapy boost had better OS. Further investigation is required to better understand the prognostic role of surgical lymph node debulking in light of radiotherapy developments. [ABSTRACT FROM AUTHOR]

• Assessment of SARS-CoV2 vaccination efficacy of four prime-boost doses. • A vaccine delivery platform that is cost-effective, user-friendly and safe. • Broad SARS-CoV-2 neutralizing antibodies response by heterologous booster vaccination. • Sustained immune response persisting until the end of the mice's lifespan. The COVID-19 pandemic has underscored the pressing need for safe and effective booster vaccines, particularly in considering the emergence of new SARS-CoV-2 variants and addressing vaccine distribution inequalities. Dissolving microneedle array patches (MAP) offer a promising delivery method, enhancing immunogenicity and improving accessibility through the skin's immune potential. In this study, we evaluated a microneedle array patch-based S1 subunit protein COVID-19 vaccine candidate, which comprised a bivalent formulation targeting the Wuhan and Beta variant alongside a monovalent Delta variant spike proteins in a murine model. Notably, the second boost of homologous bivalent MAP-S1(WU + Beta) induced a 15.7-fold increase in IgG endpoint titer, while the third boost of heterologous MAP-S1RS09Delta yielded a more modest 1.6-fold increase. Importantly, this study demonstrated that the administration of four doses of the MAP vaccine induced robust and long-lasting immune responses, persisting for at least 80 weeks. These immune responses encompassed various IgG isotypes and remained statistically significant for one year. Furthermore, neutralizing antibodies against multiple SARS-CoV-2 variants were generated, with comparable responses observed against the Omicron variant. Overall, these findings emphasize the potential of MAP-based vaccines as a promising strategy to combat the evolving landscape of COVID-19 and to deliver a safe and effective booster vaccine worldwide. [ABSTRACT FROM AUTHOR]