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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]

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]

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]

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]

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]

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.

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]

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.

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. • New surgical procedures for breast cancer poses new challenges for the radiation oncologists. • Oncoplastic breast surgery may question the ability to apply a tumour bed boost. • Skin sparing/nipple sparing mastectomies should be planned to assure clear superficial margins. • Radiation therapy should be adapted per case to provide maximal clinical benefit and reduce toxicity. • Multidisciplinary teamwork is needed to plan the most appropriate locoregional therapy. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

This paper proposes a single-dc-source, seven-level (7L) inverter scheme with a dynamic voltage gain for solar applications. The proposed circuit is created by joining the two DC-DC boost converters in series for discharging and parallel for charging. The finite set model predictive controller is used to deliver the maximum power to the load. Additional details are provided regarding the mathematical expression of volt-ampere balances. The benefits of the proposed topology over current PV inverters are stressed, proving its superiority. Through experimental validation using a lab hardware setup, an improvement in power quality and efficiency of 96.7% is guaranteed. The empirical results are demonstrated by a number of variables, including load fluctuation, modulation index variation, etc.

Abstract Background To assess the effectiveness and toxicity of radiation dose escalation for locally advanced nasopharyngeal carcinoma (LA-NPC) in patients with local and/or regional residual lesion(s) after standard treatment. Methods From November 2011 to November 2020, 259 LA-NPC patients who had local and/or regional residual lesion(s) after induction chemotherapy followed by concurrent chemoradiotherapy (IC + CCRT) from our hospital were included. The total dose of primary radiotherapy (RT) was 68.1–74.25 Gy (median, 70.4 Gy). The boost doses were 4.0–18.0 Gy (median, 9 Gy), 1.8–2.0 Gy/fraction. Results For all patients, the 5-year local relapse-free survival was 90.2%, regional relapse-free survival was 89.1%, locoregional relapse-free survival (LRRFS) was 79.5%, distant metastasis-free survival (DMFS) was 87.9%, failure-free survival (FFS) was 69.0%, and overall survival (OS) was 86.3%. LRRFS, DMFS, FFS, and OS in patients with age ≤ 65 versus > 65, plasma Epstein-Barr virus-deoxyribonucleic acid ≤ 500 versus > 500, T1–2 versus T3–4, N0–1 versus N2–3, and stage III versus stage IV showed no statistically significant differences. The interval between primary RT and boost was not a prognostic factor for LRRFS, DMFS, FFS, and OS. Males had a lower 3-year FFS rate than females (72.9% vs. 83.7%, P = 0.024). LA-NPCs with locally and regionally residual lesion(s) had the worst 3-year DMFS and OS rates compared with locally or regionally residual lesion(s) (77.7% vs. 98.8% vs. 87.4%, P = 0.014; 75.9% vs. 94.5% vs. 82.4%, P = 0.002). Conclusion Boost radiation was an option for LA-NPCs with locally and/or regionally residual lesions after receiving IC + CCRT. It warrants further prospective study. Trial registration: Retrospectively registered.

Simple Summary: Brachytherapy for prostate cancer is a method where radiotherapy is directly delivered to the prostate via surgical insertion of the radioactive source. Brachytherapy can increase the amount of radiation delivered to the prostate cancer but sometimes at the cost of increased side effects. Here, we review promising early results from alternative non-invasive techniques that now exist and can deliver similar radiotherapy doses without the need for the surgical procedure required for brachytherapy. Prostate cancer (PC) is the most common malignancy in men. Internal radiotherapy (brachytherapy) has been used to treat PC successfully for over a century. In particular, there is level-one evidence of the benefits of using brachytherapy to escalate the dose of radiotherapy compared with standard external beam radiotherapy approaches. However, the use of PC brachytherapy is declining, despite strong evidence for its improved cancer outcomes. A method using external beam radiotherapy known as virtual high-dose-rate brachytherapy boost (vHDRB) aims to noninvasively mimic a brachytherapy boost radiation dose plan. In this review, we consider the evidence supporting brachytherapy boosts for PC and the continuing evolution of vHDRB approaches, culminating in the current generation of clinical trials, which will help define the role of this emerging modality. [ABSTRACT FROM AUTHOR]

Background Hybrid immunity is associated with more durable protection against coronavirus disease 2019 (COVID-19). We describe the antibody responses following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in vaccinated and unvaccinated individuals. Methods The 55 vaccine arm COVID-19 cases diagnosed during the blinded phase of the Coronavirus Efficacy trial were matched with 55 placebo arm COVID-19 cases. Pseudovirus neutralizing antibody (nAb) activity to the ancestral strain and binding antibody (bAb) responses to nucleocapsid and spike antigens (ancestral and variants of concern [VOCs]) were assessed on disease day 1 (DD1) and 28 days later (DD29). Results The primary analysis set was 46 vaccine cases and 49 placebo cases with COVID-19 at least 57 days post–first dose. For vaccine group cases, there was a 1.88-fold rise in ancestral antispike bAbs 1 month post–disease onset, although 47% had no increase. The vaccine-to-placebo geometric mean ratios for DD29 antispike and antinucleocapsid bAbs were 6.9 and 0.04, respectively. DD29 mean bAb levels were higher for vaccine vs placebo cases for all VOCs. DD1 nasal viral load positively correlated with bAb levels in the vaccine group. Conclusions Following COVID-19, vaccinated participants had higher levels and greater breadth of antispike bAbs and higher nAb titers than unvaccinated participants. These were largely attributable to the primary immunization series. [ABSTRACT FROM AUTHOR]

Purpose: To identify efficacy, complication, and pathologic response of high-dose-rate endorectal brachytherapy (HDR-BRT) boost in neo-adjuvant chemoradiotherapy (nCRT) of locally advanced rectal cancer. Material and methods: Forty-four patients who met eligibility criteria were included in this non-randomized comparative study. Control group was recruited retrospectively. nCRT (50.40 Gy/28 fr. plus capecitabine 825 mg/m2 twice daily) was administered to both groups before surgery. In the case group, HDR-BRT (8 Gy/2 fr.) was supplemented after chemoradiation. Surgery was done 6-8 weeks after completion of neo-adjuvant therapy. Pathologic complete response (pCR) was the study's primary endpoint. Results: From 44 patients in the case and control groups, pCR was 11 (50%) and 8 (36.4%), respectively (p = 0.27). According to Ryan's grading system, tumor regression grade (TRG) TRG1, TRG2, and TRG3 were 16 (72.7%), 2 (9.1%), and 4 (18.2%) in the case, and 10 (45.5%), 7 (31.8%), and 5 (22.7%) in the control group (p = 0.118). T down-staging was found in 19 (86.4%) and 13 (59.1%) patients in the case and control groups, respectively. No grade > 2 toxicity was identified in both the groups. Organ preservation was achieved in 42.8% and 15.3% in the case and control arm (p = 0.192). In the case group, 8-year overall survival (OS) and disease-free survival (DFS) were 89% (95% CI: 73-100%) and 78% (95% CI: 58-98%), respectively. Our study did not reach median OS and median DFS. Conclusions: Treatment schedule was well-tolerated, and neo-adjuvant HDR-BRT could achieve better T downstaging as a boost comparing with nCRT, without significant complication. However, the optimal dose and fractions in the context of HDR-BRT boost needs further studies. [ABSTRACT FROM AUTHOR]

Este trabalho realiza uma comparação de três conversores CC-CC não isolados de elevado ganho estático. Esses conversores são derivados de configurações em multiestágio, multi-fase, elementos magnéticos e células multiplicadoras de tensão. O artigo revisa os métodos empregados para gerar conversores com alta taxa de conversão e caracteriza-os individualmente e, em seguida, integra as técnicas para gerar os três conversores. A análise dos conversores inclui o número de componentes, esforços de tensão e corrente, perdas nos componentes, rendimento, ganho estático e ondulação da corrente de entrada. Os conversores foram testados com uma potência de 1 kW, uma tensão de saída de 800 volts e um ganho estático superior a 13 vezes. Os resultados experimentais confirmam o estudo teórico, na qual o conversor I obteve rendimento de 87%, enquanto os conversores II e III alcançaram rendimentos em torno de 95%.

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.

Purpose: To analyze the oncological outcome in elderly (>70 years) prostate cancer after high-dose rate brachytherapy (HDB) boost. Materials/methods: In this retrospective study, patients with intermediate (IR) and high-risk (HR) prostate cancer underwent external beam radiation therapy (EBRT) followed by HDB boost with/without androgen deprivation therapy (ADT). The impact of age (≤70y vs. > 70y) was investigated. Oncological outcome focused on biochemical relapse-free survival (bRFS), cause-specific (CSS) and overall survival (OS). Late genito-urinary (GU) and gastro-intestinal (GI) toxicities were investigated. Results: From 07/08 to 01/22, 518 pts received a HDB boost, and 380 were analyzed (≤70y:177pts [46.6%] vs. > 70y:203pts [53.4%]). Regarding NCCN classification, 98 pts (≤70y: 53pts; >70y: 45pts; p = 0.107) and 282 pts (≤70y: 124pts; >70y: 158pts; p = NS) were IR and HR pts respectively. Median EBRT dose was 46 Gy [37.5–46] in 23 fractions [14–25]. HDB boost delivered a single fraction of 14/15 Gy (79%). ADT was used in 302 pts (≤70y: 130pts; >70y: 172pts; p = 0.01). With MFU of 72.6 months [67–83] for the whole cohort, 5-y bRFS, 5-y CSS and 5-y OS were 88% [85–92], 99% [97–100] and 94% [92–97] respectively; there was no statistical difference between the two age groups except for 5-y CSS (p = 0.05). Late GU and GI toxicity rates were 32.4% (G ≥ 3 7.3%) and 10.1% (no G3) respectively. Conclusions: For IR and HR prostate cancers, HDB boost leads to high rates of disease control with few late G ≥ 3 GU/GI toxicities. For elderly pts, HDB boost remains warranted mainly in HR pts, while competing comorbidity factors influence OS.

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Simple Summary: Radiotherapy plays an important role in the multidisciplinary management of breast cancer. Historically, techniques for radiation treatment of breast carcinomas have been based upon two-dimensional planning and dose application. This treatment has been associated with a relatively high risk of chronic toxicity. Modern radiotherapy techniques have made it possible to achieve a better target volume coverage with a lower critical organ radiation burden. New fractionation methods have led to shorter treatment times while improving the therapeutic ratio. All of this has permitted a reduction in both acute and chronic toxicity, and led to improvements in treatment effectiveness. Currently, partial breast irradiation is used effectively in indicated cases. This can be achieved through utilizing various irradiation techniques and a number of fractionation schemes (e.g., partial breast irradiation and accelerated partial breast irradiation). Problematic issues are related to the application of adjuvant radiotherapy in patients immediately after breast replacement surgery. Modern radiotherapy techniques are designed to permit reduced irradiation of healthy tissue, resulting in a diminished risk of adverse effects and shortened recovery times. Several randomized studies have demonstrated the benefits of increased dosage to the tumor bed area in combination with whole breast irradiation (WBI). Conventional WBI treatment following breast-conserving procedures, which required 5–7 weeks of daily treatments, has been reduced to 3–4 weeks when using hyperfractionated regimens. The dosage administration improves local control, albeit with poorer cosmesis. The method of accelerated partial breast irradiation (APBI) shortens the treatment period whilst reducing the irradiated volume. APBI can be delivered using intraoperative radiation, brachytherapy, or external beam radiotherapy. Currently available data support the use of external beam partial breast irradiation in selected patients. Modern radiotherapy techniques make it possible to achieve favorable cosmesis in most patients undergoing immediate breast reconstruction surgery, and studies confirm that current methods of external beam radiation allow an acceptable coverage of target volumes both in the reconstructed breast and in the regional lymphatic nodes. [ABSTRACT FROM AUTHOR]

Simple Summary: The benefit of administering an extra dose to the tumor bed (boost) prior or simultaneously to adjuvant breast radiotherapy in terms of local recurrence rate has already been the subject of several studies and, thus, has already found justification in appropriate patient cases. In this study, we compared two boost techniques, an intraoperative radiotherapy (IORT) boost and an intensity-modulated radiotherapy boost (IMRT), analyzing two patient collectives to determine the equivalence of the two techniques or which of the two proves superior. According to our monocenter data on tumor control, survival rates, toxicities, and cosmetic results, no significant differences were revealed between the two boost techniques, and it cannot be generalized that one technique is more advantageous than the other. The aim of this retrospective study is to compare the two boost subgroups, IORT or IMRT, in terms of overall survival (OS), progression-free survival (PFS), cosmesis, and acute and late toxicity. It shall be shown whether and which of the boost techniques offers better results with respect to the facial points, since there are already many studies on applying boost to the tumor bed after/during breast conserving surgery, and there are few which compare the different techniques. For this comparison, two subgroups of 76 patients each (n = 152), treated between 2002 and 2015, were enrolled in the study. In one subgroup, the 9 Gy boost was intraoperatively administered after complete removal of the primary tumor, while the other subgroup received the boost of 8.4 Gy percutaneously and simultaneously integrated into the tumor bed after breast conserving surgery. Both subgroups have subsequently undergone whole breast irradiation (WBI) of 50.4/50 Gy in 1.8–2 Gy per fraction. OS and the incidence of late toxicity did not differ between the two subgroups and no risk factor was found regarding PFS. Acute toxicities initially occurred significantly less (p < 0.001) in the IORT subgroup; however, after WBI took place, this difference vanished. Therefore, boost application by means of IORT or IMRT can be considered equivalent. [ABSTRACT FROM AUTHOR]

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]

Three-port converter (TPC) with non-regulated bus cannot meet the voltage stability demands of high-altitude platforms (HAPs) during daytime operations. In contrast, full-regulated bus TPC is complex in topology and inferior in power density, although it can maintain voltage stability across whole day operations. Therefore, semi-regulated bus TPCs are more suitable for this scenario, which can not only maintain voltage stability during daytime operations, but also have simple topology. However, conventional semi-regulated bus structure converts the power twice, leading to lower efficiency and power density. In order to overcome this problem, the paper proposes a novel semi-regulated bus TPC that can be used on high-altitude platforms. The topology only has one conversion between the ports. It regulates the bus voltage during the day and prevents the loss of diode during the night by directly discharging through the MOSFET and achieving high efficiency. The paper adopts GaN devices to elevate the working frequency to further improve the power density, and conduct a theoretical analysis for all working modes and provide key equations. The closed-loop transfer function of the system is deduced for stability analysis. The results show that the proposed topology has high efficiency and power density.

Background: To assess the effectiveness and toxicity of radiation dose escalation for locally advanced nasopharyngeal carcinoma (LA-NPC) in patients with local and/or regional residual lesion(s) after standard treatment.Methods: From November 2011 to November 2020, 259 LA-NPC patients who had local and/or regional residual lesion(s) after induction chemotherapy followed by concurrent chemoradiotherapy (IC + CCRT) from our hospital were included. The total dose of primary radiotherapy (RT) was 68.1-74.25 Gy (median, 70.4 Gy). The boost doses were 4.0-18.0 Gy (median, 9 Gy), 1.8-2.0 Gy/fraction.Results: For all patients, the 5-year local relapse-free survival was 90.2%, regional relapse-free survival was 89.1%, locoregional relapse-free survival (LRRFS) was 79.5%, distant metastasis-free survival (DMFS) was 87.9%, failure-free survival (FFS) was 69.0%, and overall survival (OS) was 86.3%. LRRFS, DMFS, FFS, and OS in patients with age ≤ 65 versus > 65, plasma Epstein-Barr virus-deoxyribonucleic acid  ≤ 500 versus > 500, T1-2 versus T3-4, N0-1 versus N2-3, and stage III versus stage IV showed no statistically significant differences. The interval between primary RT and boost was not a prognostic factor for LRRFS, DMFS, FFS, and OS. Males had a lower 3-year FFS rate than females (72.9% vs. 83.7%, P = 0.024). LA-NPCs with locally and regionally residual lesion(s) had the worst 3-year DMFS and OS rates compared with locally or regionally residual lesion(s) (77.7% vs. 98.8% vs. 87.4%, P = 0.014; 75.9% vs. 94.5% vs. 82.4%, P = 0.002).Conclusion: Boost radiation was an option for LA-NPCs with locally and/or regionally residual lesions after receiving IC + CCRT. It warrants further prospective study.Trial Registration:  Retrospectively registered. [ABSTRACT FROM AUTHOR]

This paper presents a triple-mode average current control (TACC) strategy to achieve unity power factor and reduce the current stress for a boost PFC converter. The controller switches among different modes in each half-line cycle, and smooth transition is ensured by mapping of the operation region. By adaptive mode shifting, it reduces the current stress and current distortion caused by non-linear effects. With valley current shaping and comparisons, the TACC controller accordingly incorporates three control laws to adapt different modes. In discontinuous conduction mode (DCM), a variable on-time is calculated while the modulation is equivalent to PWM. In critical conduction mode (CRM), a constant on-time is derived, while the switching cycle is modified to regulate the current average value. For both DCM and CRM, the switching cycle is slightly extended to realize valley switching. Furthermore, with valley current shaping, the proposed controller reuses the CRM calculation to form continuous conduction mode (CCM) control law. To make the control laws compatible, normalized mapping and design rules are provided with respect to mode boundaries. This allows the TACC controller to automatically switch among different modes. Finally, experimental results prove the effectiveness of the controller in reducing the current stress and enlarging the preferable power range. [ABSTRACT FROM AUTHOR]

Purpose: To compare biochemical recurrence-free survival (BRFS) and toxicity outcomes of high dose rate brachytherapy (HDRB) and stereotactic body radiotherapy (SBRT) boost after elective nodal irradiation for high/very high-risk prostate cancer. Materials and Methods: A retrospective analysis was performed in 149 male patients. In 98 patients, the boost to the prostate was delivered by HDRB as 2 fractions of 10 Gy (EQD2 for α/β = 1.5; 66 Gy) or 1 fraction of 15 Gy (EQD2 for α/β = 1.5; 71 Gy). In 51 male patients, SBRT was used for the boost delivery (3 fractions of 7 Gy; EQD2 for α/β = 1.5; 51 Gy) because brachytherapy equipment was out of order. Results: In 98 patients that received HDRB boost, 3- and 5-year BRFS were 74.6% and 66.8%. Late grade-II genitourinary toxicity was detected in 27, grade-III in 1 case. Grade-II (maximum) rectal toxicity was diagnosed in nine patients. For 51 male patients that received SBRT boost, 3- and 5-year BRFS was 76.5% and 67.7%. Late grade-II (maximum) genitourinary toxicity was detected in five cases, late grade-II rectal toxicity in four cases. Other three patients developed late grade-III-IV rectal toxicity that required diverting colostomy. SBRT boost was associated with higher maximum dose to 2 cm3 of anterior rectal wall (D2cm³rectum) compared to HDRB: 92% versus 55% of dose to prostate. Severe rectal toxicity was negligible at EQD2 D2cm³rectum <85 Gy and EQD2 D5cm³ rectum <75 Gy. Conclusion: Our results indicate similar 3- and 5-year BRFS in patients with high/very high-risk prostate cancer who received HDRB or SBRT boost, but SBRT boost is associated with higher rate of severe late rectal toxicity. [ABSTRACT FROM AUTHOR]

Purpose: To identify patient, tumor, and treatment-related factors, which predict cosmesis in breast cancer survivors treated with adjuvant whole breast irradiation (WBI) plus high-dose-rate (HDR) multicatheter interstitial brachytherapy (MIBT) boost after breast conservation surgery. Material and methods: At least 12 months after completion of radiotherapy, cosmetic outcomes were measured both objectively with BCCT.core software (using a front view digital photograph), and subjectively according to Harvard's criteria. MIBT dose fractionation regimen was 13.6 Gy/4 fractions (bid). To evaluate the correlation between cosmetic scores and dose-volume histogram (DVH) parameters, WBI and MIBT plans were retrospectively analyzed, and ipsilateral skin and breast biologically equivalent dosimetric indices were recorded (a/ß = 3 Gy). A multivariate ordinal logistic regression model was used for statistical analysis. Results: Twenty-eight consecutive patients were enrolled into this study. The median time from completion of radiation therapy to cosmesis scoring was 18 months. In evaluation with BCCT.core software, no patient was scored as excellent. Cosmesis was good in 18%, fair in 50%, and poor in 32% of patients. According to Harvard's scale, 10.5% of patients had excellent cosmesis, and 43%, 28.5%, and 18% of patients had good, fair, and poor scores, respectively. In univariate analysis, patients with higher absolute MIBT V29Gy (cc), those treated with irradiation of regional lymphatics (odds ratio = 5), and patients with larger breast volumes had statistically significant lower Harvard's scores. In the multivariate model, none of the mentioned factors remained statistically significant, except for a trend for poorer cosmesis in patients with higher absolute MIBT V29Gy (p-value = 0.066). Conclusions: Based on the results of this study, MIBT breast V29Gy, regional nodal irradiation, and larger breast volumes are the potential factors, which could predict cosmesis. [ABSTRACT FROM AUTHOR]

THE CROSS BORDER COOPERATION BETWEEN ROMANIA AND UKRAINE HAD A SLOW START BUT WITH THE IMPLEMENTATION OF THE JOINT OPERATIONAL PROGRAMME ROMANIA-UKRAINEMOLDOVA 2007-2014 AND AFTER THAT THE SECOND PROGRAMME FOCUSED ONLY ON ROMANIA AND UKRAINE, THE CROSS BORDER COOPERATION BETWEEN THIS TWO COUNTRIES BEGAN TO INTENSIFY, CREATING THE COOPERATION FRAMEWORK AT ALL LEVELS. BECAUSE OF THIS, THE PRIVATE OR THE PUBLIC SECTORS EITHER FROM ROMANIA OR UKRAINE BEGUN TO CREATE THEIR OWN PROJECTS OR THEIR OWN FORM OF COOPERATION. THIS IS HOW STARTING WITH A COOPERATION BETWEEN CERTAIN LINE, DICTATED BY THE JOINT OPERATIONAL PROGRAM, THE TWO STATES BEGAN TO CONSIDER THE REAL BENEFITS OF COOPERATION. [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.

Increased high-power exigency in industries insists for high step-up converters. Boost topology of DC–DC converters is the simplest and most used structure in numerous applications. This paper proposes a non-isolating type novel cluster switched inductor Boost (CSIB) hybrid converter having elevated voltage adaptation ratio. The key attribute of the projected CSIB converter is it gives high gain ratio when compared to other Boost topologies. With the same equivalent inductance value (while transferring energy to the load) as that of conventional converters, the proposed CSIB converter furnishes high voltage conversion ratio and adds an additional feature of proposed CSIB Hybrid DC–DC converter. With high conduction losses at high duty ratio and high parasitic resistance, distributed inductor shows a prominent role in increasing the gain of the converter and is the case in proposed CSIB converter. Transformer-less operation of novel CSIB converter reduces the size and avoids EMI/EMC effects, which is an added advantage. The Novel Cluster Switched Inductor Boost (CSIB) hybrid DC–DC converter in CCM operation is compared with Hybrid Boost and Symmetrical Hybrid Switched Inductor converter (SH-SLC) topologies to validate its performance. Simulation analysis is presented using MATLAB/SIMULINK software. [ABSTRACT FROM AUTHOR]