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Making informed future decisions about solar radiation modification (SRM; also known as solar geoengineering)—approaches such as stratospheric aerosol injection (SAI) that would cool the climate by reflecting sunlight—requires projections of the climate response and associated human and ecosystem impacts. These projections, in turn, will rely on simulations with global climate models. As with climate-change projections, these simulations need to adequately span a range of possible futures, describing different choices, such as start date and temperature target, as well as risks, such as termination or interruptions. SRM modeling simulations to date typically consider only a single scenario, often with some unrealistic or arbitrarily chosen elements (such as starting deployment in 2020), and have often been chosen based on scientific rather than policy-relevant considerations (e.g., choosing quite substantial cooling specifically to achieve a bigger response). This limits the ability to compare risks both between SRM and non-SRM scenarios and between different SRM scenarios. To address this gap, we begin by outlining some general considerations on scenario design for SRM. We then describe a specific set of scenarios to capture a range of possible policy choices and uncertainties and present corresponding SAI simulations intended for broad community use.

Aluminum alloy A356-T6 and automotive steel sheet SAPH440 were joined using friction stir spot welding and self-piercing riveting. The maximum tensile shear strength values in weld joints were approximately 3.5 kN at a rotation speed of 500 rpm and plunge depth of 1.0 mm. It was confirmed that the intermetallic compound layer of weld joints below 9.23 m did not exceed the permissible thickness 10 m of Al–Fe joints. The self-piercing riveting joints exhibited maximum tensile- shear strength of 7.9 kN, which was higher than that of the weld joints. However, during the riveting process, cracking appeared in the joint on the aluminum side, which was caused by lack of ductility of cast aluminum. In addition, it was observed that the cracks on the aluminum side were getting larger, as the radius of the lower mold increased. Алюминиевый сплав А356-Т6 и автомобильную листовую сталь SAPH440 соединяли с помощью точечной ротационной сварки трением и самопробивной клепки. Максимальный предел прочности на сдвиг при растяжении для сварных соединений составлял примерно 3,5 кН при скорости вращения 500 об/мин и глубине проникновения 1,0 мм. Доказано, что слой интерметаллидов сварных соединений толщиной менее 9,23 мкм не превышал допустимый уровень в 10 мкм для соединений Al–Fe. Клепаные соединения имели предел прочности 7,9 кН в отличие от сварных соединений. Однако при клепке на алюминии появлялись трещины ввиду низкой пластичности литого материала, при этом трещины подрастали по мере увеличения радиуса нижней формы.

The ITER plasma control system (PCS) has successfully completed its final design for the first plasma (FP) and engineering operations (EOs) phase and plant system commissioning has begun as ITER prepares for this first operation phase. Commissioning of the essential plant systems will continue as each plant system is completed and made ready for operation. Tokamak assembly has begun with the base and lower cylinder of the cryostat and the lower most poloidal field (PF) coil installed in the tokamak pit. The first vacuum vessel (VV) sector and accompanying two toroidal field (TF) coils are being prepared for transfer to the pit. Once the tokamak is assembled, the cryostat top lid is closed and pump down begins, this will start approximately one year of integrated commissioning (IC) to prepare all of the relevant plant systems for FP operation. After a scheduled one month of plasma operation with the goal of achieving a plasma current > 100 kA for at least 100 ms, there will be about six months of EO to complete commissioning of the superconducting central solenoid, PF, and TF magnet systems to full current, without plasma, to complete this initial ITER operation phase. The PCS final design for FP will be described as well as the IC sequence of the main plant systems required for this operations phase. The plans for the FP operation campaign will be described, including specific challenges present on ITER due to large VV eddy currents, issues associated with electron cyclotron heating (ECH) assist, neutral pressure and impurities. This will be followed by the EO phase to commission full current operation of the superconducting magnets, possibly including plasma operation at full TF of 5.3 T to have improved conditions both for Ohmic plasma initiation and ECH absorption.

The ITER Plasma Control System (PCS) is an essential component for ITER operations. It will include multiple controls loops as well as a number of support functions dedicated to providing input control parameters and distributing commands to actuators. In addition, a supervisory system within the PCS architecture will manage the orchestration of the PCS control loops during the discharge as well as an Exception handling system to react to real-time changes in the plasma and/or in the plant systems. To investigate and develop controllers and supervisory techniques, a simulation platform is being developed to support the staged evolution of the PCS. The PCS Simulation Platform (PCSSP), based on Matlab/Simulink, is used to design and assess PCS control functions and verify the consistency of the PCS architecture. Moreover, the PCSSP will assist in implementing PCS algorithms, directly deploying PCS code on the ITER Real Time Framework (RTF). This paper will present the overall work-flow processes from control simulations, control assessment, code generation, interfaces and deployment into the RTF and PCS commissioning. This will include interface management and co-ordination with ITER investment protection, the pulse scheduling system, and the plant system configuration during operations. How the entire preparation process will be managed, for ITER first plasma operations will be reported here.

Background Dermatofibrosarcoma protuberans (DFSP) is a rare and locally aggressive tumour, with a high recurrence rate, even after complete surgical excision. Adjuvant radiotherapy (RT) has been suggested to reduce the risk of local recurrence after inadequate surgical resection in patients with narrow or positive surgical margins. However, the overall efficacy of adjuvant RT has not been well studied because of the rarity of DFSP and lack of an appropriate comparison group. Objective We sought to evaluate the efficacy of adjuvant RT for DFSP by conducting a systemic review and meta-analysis to provide a more evidence-based measure of its effectiveness. Methods We conducted a systemic review of articles published before 31 June 2015. Due to the rarity of the disease, we included all studies that reported DFSP patients who received adjuvant RT (postoperatively). The pooled recurrence rates were analysed from these extracted data. Results Twelve studies met the inclusion criteria. The pooled estimate of the recurrence rate for all adjuvant radiotherapy was 11.74% (95% CI 7.4-17.38; n = 167). Patients with positive/close had a pooled recurrence rate of 14.23% (95% CI 8.13-22.49; n = 92), whereas there was no recurrence in patients with negative margins. The pooled estimate of the recurrence rate between surgery alone and surgery combined with adjuvant radiotherapy showed no significant difference (odds ratio 0.31, P = 0.07), although there was a trend that adjuvant RT had a lower recurrence rate than surgery alone. Conclusion Adjuvant RT might be considered for all patients undergoing surgical excision, even if a negative surgical margin has been achieved. Furthermore, for patients with large or recurrent tumours, especially when wide excision with negative margin would result in a significant functional or cosmetic deficit, postoperative radiotherapy is highly recommended in order to achieve a lower recurrence rate.

Background: Myocardial injury after noncardiac surgery (MINS) was defined as prognostically relevant myocardial injury due to ischemia that occurs during or within 30 days after noncardiac surgery. The study’s four objectives were to determine the diagnostic criteria, characteristics, predictors, and 30-day outcomes of MINS. Methods: In this international, prospective cohort study of 15,065 patients aged 45 yr or older who underwent in-patient noncardiac surgery, troponin T was measured during the first 3 postoperative days. Patients with a troponin T level of 0.04 ng/ml or greater (elevated “abnormal” laboratory threshold) were assessed for ischemic features (i.e., ischemic symptoms and electrocardiography findings). Patients adjudicated as having a nonischemic troponin elevation (e.g., sepsis) were excluded. To establish diagnostic criteria for MINS, the authors used Cox regression analyses in which the dependent variable was 30-day mortality (260 deaths) and independent variables included preoperative variables, perioperative complications, and potential MINS diagnostic criteria. Results: An elevated troponin after noncardiac surgery, irrespective of the presence of an ischemic feature, independently predicted 30-day mortality. Therefore, the authors’ diagnostic criterion for MINS was a peak troponin T level of 0.03 ng/ml or greater judged due to myocardial ischemia. MINS was an independent predictor of 30-day mortality (adjusted hazard ratio, 3.87; 95% CI, 2.96–5.08) and had the highest population-attributable risk (34.0%, 95% CI, 26.6–41.5) of the perioperative complications. Twelve hundred patients (8.0%) suffered MINS, and 58.2% of these patients would not have fulfilled the universal definition of myocardial infarction. Only 15.8% of patients with MINS experienced an ischemic symptom. Conclusion: Among adults undergoing noncardiac surgery, MINS is common and associated with substantial mortality.

A decade long operation of KSTAR has contributed significantly to operation of superconducting tokamak device and advancement of tokamak physics which will be beneficial for the ITER and K-DEMO programs. Even with limited heating capability, various conventional as well as new operating regimes have been explored and achieved great performance. As examples, a long pulse H-mode operation with and without the ELM-crash was well over 60 seconds and over 30 seconds, respectively. Unique capabilities of KSTAR allowed to improve control capability of harmful instabilities and have been instrumental for many exciting new physics. The intricate IVCC system has been a great perturbation tool in studying of threshold power of the L/H transition in the presence of non-axisymmetric fields, rotation physics due to NTV effects, heat dispersal in divertor system and predictive control of the ELM-crash with a priori modeling. The state-of-the-art 2D/3D microwave imaging systems uncovered many new exciting new physics in the MHD and turbulence transport physics. They are validation of q0agt;1 right after the sawtooth crash, self-consistent asymmetric distribution of plasma turbulence amplitude and flow in the presence of 2/1 island, and underlying physics of low frequency turbulence induced by 3D resonant fields in suppression of the ELM-crash through non-linear interaction with the ELMs. In the turbulence area, non-diffusive "avalanche" transport event and role of quiescent coherent mode in confinement are studied. To accommodate anticipating higher performance of the KSTAR plasmas with the increased heating powers (NBI and ECH), new divertor/internal interface with full active cooling system will be implemented after the increased heating power systems and new current drive systems are fully tested. Upgrade plan for the internal hardware and efficient current drive system may allow a long pulse operation of higher performance plasmas at βNagt;3.0 with fbs~0.5 and Tiagt;10keV. a#13; a#13

We describe Pervasive Refusal Syndrome, an important but rare, debilitating condition that may present to paediatric services. Although previous reports have described improvement seen with care delivered in the mental health setting, we have demonstrated treatment predominately delivered in a paediatric ward environment associated with successful recovery.

Flip chip is one of the packaging techniques for high-performance components. There is a greater demand on integrating more functions in a smaller chip nowadays. This leads to the increase of I/O density. Organic substrate is the bottleneck of the high-density packaging. A silicon interposer with through-silicon vias (TSVs) is commonly used to provide a platform with a high wiring density to redistribute I/Os. After I/O redistribution, larger solder joints with a larger pitch can be used to connect the interposer to the organic substrate. In this paper, a TSV-based silicon interposer with a cavity and copper pillars for 3-D packaging is presented. The cavity hosts the flip-chip device. There are copper-filled TSVs in the cavity to provide the electrical interconnections to the backside of the interposer. Flip-chip solder bumps are electroplated on the copper pillars. Subsequent to the flip-chip assembly process, the device is seated in the cavity entirely. The backside of the flip chip is lower than that of the surface of the interposer. This provides a better environment for further die stacking on the surface of the interposer. The microfabrication process of the proposed silicon interposer with TSVs in cavities is discussed in detail.

HeeSeon Bang, W. R. Lee, Seong Min Hong, S. Y. Lee. J. H. Song, J. M. Kim, and HanSur Bang. Corresponding author is HeeSeon Bang with the email address: banghs@chosun.ac.kr.

This book surveys the history of the German family in the nineteenth and twentieth centuries. The contributions deal with the influence of industrialisation on family life in town and country, with rural families and communities under the impact of social and economic change, and with the role and influence of the family in the lives of men and women in the newly-emerged working class. Research on the history of the family had so far, at the point of this book’s publication in 1981, concentrated on England and France; this book adds an important comparative dimension by extending the discussion into Central Europe and bringing fresh evidence and interpretation to bear on the wider debate about the effects of industrialisation on family structure and family life as a whole. The authors approach the subject from a variety of perspectives, including social anthropology, oral history, economic history and feminist studies. This book is ideal for students of history, particularly the history of Germany.

This book, first published in 1986, surveys the history of rural society in Germany from the eighteenth century to the present day. The contributions include studies of Junker estates and small farming communities, serfs and landless labourers, maidservants and worker-peasants. They demonstrate the variety and complexity of the social division that structures the rural economy. Throughout the book there is an emphasis on the conflicts that divided rural society, and the ways and means in which these were expressed, whether in serf strikes in eighteenth-century Brandenburg, village gossip in early twentieth-century Hesse, or factional struggles over planning permission in present-day Swabia. The rural world emerges not as traditional, passive and undifferentiated , but as actively participating in its own making; not only responding to the changes going on around it, but exploiting them for its own purposes and influencing them in its own way. This book is ideal for students of history, particularly German history.

Magnesium alloys are expected to be widely used fur the parts of structural and electronic appliances due to their lightweight and EMI shielding characteristics. While the die casting has been mainly used to manufacture the parts from the magnesium alloys, the press forming is considered as an alternative to the die casting for saving the manufacturing cost and improving the structural strength of the magnesium alloy parts. However, the magnesium alloy has low formability at room temperature and therefore, in many cases, forming at elevated temperatures is necessary to obtain the required material flow without failure. In the present study, square cup deep drawing tests using the magnesium alloy AZ31 sheet were experimentally conducted at various elevated temperatures as well as room temperature, and the corresponding finite-element simulations, which calculated the damage evolution based on the Oyane`s criterion, were conducted using the stress-strain relations from the tensile tests at various temperatures. The formability predictability by the finite-element analysis was investigated by comparing the predicted damage distributions over the deformed AZ31 sheet at elevated temperatures with the corresponding experimental deformations with failures.

Purpose This study was designed to examine the efficacy of low-dose intrathecal morphine (ITM) on extubation times and pain control after cardiac surgery.

ObjectivesTo evaluate the psychometric properties of the KINDL questionnaire in an Asian population. Methods: Consecutive patients with diabetes mellitus (DM) and healthy subjects were recruited to complete the English KINDL questionnaire. The inclusion criteria for patients were age 8–16 years, English-speaking, diagnosed with DM and absence of co-morbid conditions. Results:Thirty children with DM (mean age: 10.7 ± 1.35 years; 11M) and 39 healthy subjects (mean age: 10.6 ± 1.23 years, 17M) completed the child version whereas 31 adolescents with DM (mean age: 14.5 ± 1.48 years; 15M) and 32 healthy subjects (mean age: 14.3 ± 0.87 years, 16M) completed the adolescent version. Overall, children with DM reported better HRQoL than healthy children. Although this appeared counter-intuitive, several explanations are possible: (1) the development of resilience to the disease over time, (2) our subjects are well-managed, (3) response shift, (4) the provision of high quality medical care, (5) compared to normal children, diabetic subjects and their family pay greater attention to health issues. The reliability coefficients were (overall, scales): KINDL-Kid DM (0.79, 0.44–0.65), KINDL-Kid Healthy (0.71, 0.60–0.80), KINDL-Kiddo DM (0.77, 0.37–0.74) and KINDL-Kiddo Healthy (0.84, 0.21–0.79). Conclusions: The KINDL questionnaire appeared promising for use in Asian children. However, further validation in a sample more representative of the general population is required.

Local excision of rectal lesions is being increasingly undertaken, especially in those unfit for major surgery. The traditional transanal approach is often cumbersome and limited to low and mid rectal lesions. Transanal endoscopic microsurgery (TEMS) is being used to excise both benign and malignant rectal lesions, including those in the upper rectum.Prospective analysis of all patients undergoing a TEMS excision between January 1997 and December 2000 in a specialized colorectal unit.Forty patients underwent a TEMS resection, with a mean age of 72 years (SD, 10 years). The mean distance of the lesions from the anal verge was 9.8 cm (SD, 3.1 cm). In 24 patients, the lesion was locatedor=10 cm from the anal verge, making them unsuitable for traditional transanal resection. The mean operative time was 91 minutes (SD, 34 minutes), and the mean postoperative stay was 3 days (SD, 1.5 days). No mortality was associated with the procedure, and there was minimal morbidity in 15%. There has been no recurrence in the 18 patients who had a malignant lesion excised.The TEMS operating system provides the surgeon with a suitable alternative for the resection of benign and malignant rectal neoplasms in selected patients. It has the advantage of providing visual clarity of the operative field, allowing more precise dissection and a minimally invasive approach to mid and upper rectal lesions. There has been no mortality and minimal morbidity. We advocate its inclusion as part of a colorectal surgeon's operative armamentarium for these selected cases.

PURPOSE: Laparoscopic techniques for bowel resection have not enjoyed widespread popularity. Of concern is that long-term follow-up data of cancer specific outcomes is not yet available. The aim of our study was to examine the long-term outcome of abdominoperineal resection for cancer done laparoscopically compared with a similar cohort who underwent open surgery. METHODS: A retrospective review was performed of all abdominoperineal resections done in our center between 1992 and 2000, comparing the cancer-specific outcomes of the laparoscopic cohort with the open cohort. The analysis was performed on an intention-to-treat basis and survival analysis was calculated by the techniques of Kaplan-Meier. RESULTS: Eighty-nine patients were reviewed. Twenty-eight operations were done laparoscopically, and 61 were open. The two groups were matched for age and stage of disease. There was no difference in mean length of overall survival (open = 30.3 months; laparoscopic = 40.8 months; P = 0.355 log rank). No difference in overall recurrence rate, isolated recurrence rate, or distant recurrence rates was seen nor was there any difference in the disease-free period. There was no difference in the number of lymph nodes harvested from the resected specimens, and the distance to the lateral margins or involvement of tumor in the lateral margins between the two groups was the same. The laparoscopic cohort did have a significantly shorter length of stay (mean, 13 days) compared with the open cohort (mean, 18 days), P = 0.008 Mann-Whitney U test. CONCLUSIONS: Laparoscopic abdominoperineal resection of the rectum for cancer does not compromise cancer-specific survival outcomes. The patients avoid a large abdominal wound, which improves cosmesis and presumably is responsible for the significantly shorter length of stay.

In the KSTAR Tokamak, a “Tangential Thomson Scattering” (TTS) diagnostic system has been designed and installed to measure electron density and temperature profiles. In the edge system, TTS has 12 optical fiber bundles to measure the edge profiles with 10–15 mm spatial resolution. These 12 optical fibers and their spatial resolution are not enough to measure the pedestal width with a high accuracy but allow observations of L-H transition or H-L transitions at the edge. For these measurements, the prototype ITER edge Thomson Nd:YAG laser system manufactured by JAEA in Japan is installed. In this paper, the KSTAR TTS system is briefly described and some TTS edge profiles are presented and compared against the KSTAR Charge Exchange Spectroscopy and other diagnostics. The future upgrade plan of the system is also discussed in this paper.

For a high-performance, advanced tokamak mode in KSTAR, we have been developing a real-time control system of MHD modes such as sawtooth and Neo-classical Tearing Mode (NTM) by ECH/ECCD. The active feedback control loop will be also added to the mirror position and the real-time detection of the mode position. In this year, for the stabilization of NTM that is crucial to plasma performance we have implemented open-loop ECH antenna control system in KSTAR Plasma Control System (PCS) for ECH mirror movement during a single plasma discharge. KSTAR 170 GHz ECH launcher which was designed and fabricated by collaboration with PPPL and POSTECH has a final mirror of a poloidally and toroidally steerable mirror. The poloidal steering motion is only controlled in the real-time NTM control system and its maximum steering speed is 10 degree/sec by DC motor. However, the latency of the mirror control system and the return period of ECH antenna mirror angle are not fast because the existing launcher mirror control syst...

Background: Myocardial injury after noncardiac surgery (MINS) was defined as prognostically relevant myocardial injury due to ischemia that occurs during or within 30 days after noncardiac surgery. The study's four objectives were to determine the diagnostic criteria, characteristics, predictors, and 30-day outcomes of MINS. Methods: In this international, prospective cohort study of 15,065 patients aged 45 yr or older who underwent in-patient noncardiac surgery, troponin T was measured during the first 3 postoperative days. Patients with a troponin T level of 0.04 ng/ml or greater (elevated abnormal laboratory threshold) were assessed for ischemic features (i.e., ischemic symptoms and electrocardiography findings). Patients adjudicated as having a nonischemic troponin elevation (e.g., sepsis) were excluded. To establish diagnostic criteria for MINS, the authors used Cox regression analyses in which the dependent variable was 30-day mortality (260 deaths) and independent variables included preoperative variables, perioperative complications, and potential MINS diagnostic criteria. Results: An elevated troponin after noncardiac surgery, irrespective of the presence of an ischemic feature, independently predicted 30-day mortality. Therefore, the authors' diagnostic criterion for MINS was a peak troponin T level of 0.03 ng/ml or greater judged due to myocardial ischemia. MINS was an independent predictor of 30-day mortality (adjusted hazard ratio, 3.87; 95% CI, 2.96-5.08) and had the highest population-attributable risk (34.0%, 95% CI, 26.6-41.5) of the perioperative complications. Twelve hundred patients (8.0%) suffered MINS, and 58.2% of these patients would not have fulfilled the universal definition of myocardial infarction. Only 15.8% of patients with MINS experienced an ischemic symptom. Conclusion: Among adults undergoing noncardiac surgery, MINS is common and associated with substantial mortality.

In this paper, we propose an efficient approach to numerical integration of functions of two variables, where a grid set with a fixed number of vertices is to be chosen such that the error between the numerical integral and the exact integral is minimized. Two schemes are first developed for sufficiently smooth functions. One is based on barycenter rule on a rectangular partition, while the other is on a triangular partition. A scheme for non-sufficiently smooth functions is also developed. For illustration, several examples are solved by using the proposed schemes.

A major problem facing battery-powered electric vehicles is in their batteries: weight and charge capacity. Thus, a battery-powered electric vehicle only has a short driving range. To travel for a longer distance, the batteries are required to be recharged frequently. In this paper, we construct a model for a battery-powered electric vehicle, in which driving strategy is to be obtained such that the total travelling time between two locations is minimized. The problem is formulated as an optimization problem with switching times and speed as decision variables. This is an unconventional optimization problem. However, by using the control parametrization enhancing technique (CPET), it is shown that this unconventional optimization is equivalent to a conventional optimal parameter selection problem. Numerical examples are solved using the proposed method.

PURPOSE To examine the natural history of patients who have received definitive radiation therapy alone for clinically localized prostate cancer and have an increasing prostate-specific antigen (PSA) profile. PATIENTS AND METHODS One hundred fifty-one men with an increasing PSA profile after definitive radiotherapy were identified. The subsequent natural history of these men, including local recurrence, distant metastasis, and survival, was examined. In 119 men, posttreatment PSA doubling times (PSADT) were calculated using linear regression. Cox regression models were used to examine the effect of clinical and treatment variables on clinical failure and survival. RESULTS Patients with high pretreatment PSA values, high Gleason scores, and T3 tumors were more likely to develop a PSA elevation. The median calculated post-treatment PSADT was 13 months, and 95% of patients had posttreatment PSADT of less than 3 years. PSADT was correlated with tumor stage and Gleason score. Five years after PSA elevation, the estimated rate of clinical local recurrence is 26% and the estimated rate of distant metastases is 47%. Rapid PSADT (< 12 months) and a short interval from the end of treatment to PSA elevation (< 12 months) were significant independent predictors of distant metastases. The estimated rates of overall and cause-specific survival 5 years after PSA elevation are 65% and 76%, respectively. Gleason grade is the only significant independent predictor of overall and cause-specific survival after PSA elevation. CONCLUSION The natural history of men who have an increasing PSA profile following definitive radiotherapy is heterogeneous. In the absence of salvage therapy, at least three quarters of men will have clinical evidence of recurrent disease 5 years after a PSA elevation is detected. Men with a rapid posttreatment PSADT and a short interval from the end of treatment to an increasing PSA profile are at a very high risk of developing distant metastasis within 5 years of PSA elevation.

Phosphor converted LED is one of the commonly used components in solid state luminaires. Among the packaging processes involved, phosphor deposition is a critical step, which controls the overall optical performance of LEDs. There are several phosphor deposition methods, among which disperse dispensing and conformal coating methods are widely used. In these two methods, phosphor materials are applied directly on top of the LED chip. The phosphor materials are heated up by the LED chip during the operation. The behavior of phosphor materials highly depends on their temperature. The emission efficiency decreases as temperature increases. High phosphor temperature may also introduce reliability problems. The situation can be improved by adopting a remote phosphor method. Some high power LEDs packages utilize silicone lens to increase the light extraction efficiency. It is difficult to apply a remote phosphor layer on the convex surface using a regular dispensing process. In this paper, an innovative remote phosphor deposition method is proposed for the packages with silicone lens. Phosphor slurry is dispensed directly on the silicone lens specially designed with a step. It flows and spreads on the dome, and stops when it reaches the edge of the step. The unique step feature stops the phosphor slurry from overflowing. The thickness of the remote phosphor layer can be easily adjusted by changing the dispensing volume. This dispensing method increases the throughput and reduces the processing cost.

We describe the application of CT-MRI fusion software for 3D conformal radiotherapy in two patients with localized prostate cancer who had significantly altered pelvic anatomy due to prior surgery. Patient A had a hemipelvectomy for fibrosarcoma and Patient B had an abdominoperineal resection (APR) for rectal carcinoma. Using the Picker AcQSIM 3D treatment planning software equipped with CT-MRI fusion capabilities, we were able to construct 3D conformal treatment plans for the two patients. The CT-MRI fusion was invaluable in the 3D conformal treatment planning of these cases with distorted pelvic anatomy. It allowed for accurate identification of the clinical target volume (CTV) and was also able to better visualize normal structures so that the radiation beams could be placed to minimize toxicity to the normal tissues.

To determine whether systematic biopsy can help predict treatment outcome in men with clinically localized prostate cancer treated with external-beam radiation therapy alone.Two hundred twenty-four men with clinically localized prostate cancer underwent ultrasound-guided systematic biopsies before undergoing external-beam radiation therapy. Median follow-up was 25 (range, 4-80) months. Treatment failure after irradiation was defined as a prostate-specific antigen (PSA) level greater than 1.5 ng/mL and rising.Univariate analysis demonstrated that the percentage of biopsy specimens involved by cancer was predictive of relapse-free survival. Patients in whom more than 50% of biopsy specimens were positive had significantly lower relapse-free survival rates at 36 months than patients with 50% or fewer positive biopsy specimens. After stratifying patients according to pretreatment PSA level, however, the percentage of positive biopsy specimens was no longer prognostic. Multivariate analysis demonstrated that pretreatment PSA level was the only variable that enabled prediction of relapse-free survival.Systematic biopsy added little further prognostic information beyond that provided by pretreatment PSA level. A larger series with longer follow-up is necessary to verify these results.

In this paper, the phosphor-converted white light LED was studied. Samples under investigation included various types of GaN blue LED chips and phosphor powders with different concentrations. Using an integrating sphere and spectrometer system, the effects of blue LED chips and phosphors on the optical performance of white light LED were analyzed comprehensively. From the experimental study, several conclusions could be drawn. The relationships between the radiant flux of the blue LED chip, the spectrum of the LED and the phosphor, and the optical performance of the resulting white light LED are discussed in detail in this paper.

PURPOSE To determine the 5-year rate of survival with no evidence of disease (NED) using strict biochemical criteria in men with prostate cancer treated by external-beam radiotherapy alone and to examine possible clinical and treatment factors that predict the likelihood of NED survival. MATERIALS AND METHODS Five hundred men with clinically localized prostate cancer consecutively treated with external-beam radiotherapy alone with no prior, concomitant, or adjuvant endocrine therapy were identified. All patients had serial serum prostate-specific antigen (PSA) values determined after treatment and 451 patients had pretreatment PSA values determined. The median follow-up duration is 20 months (range, 2 to 72; mean, 36). RESULTS The 5-year rate of overall survival in this group of patients was 80%. The 5-year rate of survival without clinical evidence of disease (cNED) was 72%. The 5-year rate of survival without evidence of clinical, radiographic, or biochemical relapse (bNED) was 51%. Multivariate analysis demonstrated that a pretreatment serum PSA level < or = 15 ng/mL was the most important predictor of bNED survival (P < .0001). Patients with early-stage (T1, T2a/b) tumors and a pretreatment serum PSA less than 15 ng/mL had a 3-year rate of bNED survival of 86%. The rate of bNED survival for patients with a pretreatment PSA level greater than 15 ng/mL was 38% at 3 years. CONCLUSION Pretreatment serum PSA level is the most important predictor of treatment outcome in this group of patients treated with definitive radiotherapy alone. External-beam radiation alone can produce acceptable early rates of bNED survival in patients with clinically organ-confined tumors and a pretreatment PSA level < or = 15 ng/mL. To produce acceptable results in those patients with pretreatment PSA levels more than 15 ng/mL, effective adjuvant treatments in addition to aggressive local treatments are necessary.

The Thomson scattering diagnostic system is successfully installed in the Korea Superconducting Tokamak Advanced Research (KSTAR) facility. We got the electron temperature and electron density data for the first time in 2011, 4th campaign using a field programmable gate array (FPGA) based signal control board. It operates as a signal generator, a detector, a controller, and a time measuring device. This board produces two configurable trigger pulses to operate Nd:YAG laser system and receives a laser beam detection signal from a photodiode detector. It allows a trigger pulse to be delivered to a time delay module to make a scattered signal measurement, measuring an asynchronous time value between the KSTAR timing board and the laser system injection signal. All functions are controlled by the embedded processor running on operating system within a single FPGA. It provides Ethernet communication interface and is configured with standard middleware to integrate with KSTAR. This controller has operated for two experimental campaigns including commissioning and performed the reconfiguration of logic designs to accommodate varying experimental situation without hardware rebuilding.

Purpose To determine whether sclerosis of the laryngeal cartilages was a predictor of a poor outcome in patients with stage T3 glottic cancer treated with radiation therapy. Materials and methods Thirty-three patients with stage T3 glottic cancer underwent computed tomography (CT) before radiation therapy. Twenty-two patients underwent posttreatment CT. The presence of cartilage sclerosis, cartilage erosion, marrow invasion, and cartilage necrosis was determined. Results Nineteen of the 33 patients had cartilage sclerosis at CT. Seventeen patients had sclerosis of a single laryngeal cartilage (14 arytenoid, two cricoid, and one thyroid), and two had sclerosis of adjacent laryngeal cartilages (arytenoid and cricoid in both cases). Of the 17 patients with isolated laryngeal cartilage sclerosis, disease was controlled with radiation therapy alone in 15 and with salvage laryngectomy in two. Both patients with cricoid and arytenoid sclerosis died of their original cancer despite undergoing early salvage laryngectomy. Of the 14 patients without sclerosis, eight had no evidence of disease, two died of their disease, and four died of intercurrent disease. Conclusion T3 glottic cancer with isolated laryngeal cartilage sclerosis can be cured with radiation therapy.

This article describes the detailed ocular pathology found in a premature neonate, born at 34 weeks, with multiple congenital anomalies resulting from de novo trisomy 1q32-qter. The ocular defects include goniodysgenesis, persistent tunica vasculosa lentis and hyaloid vessels, hypopigmentation of the posterior iris epithelium, ectopia of the ciliary processes, and abnormal insertion of the ciliary muscle and cataract. This is the first report of the detailed ocular pathology in a case of trisomy 1q and is also unusual in that the chromosomal defect has apparently arisen de novo in the proband.

The Russian Model 249 circular suturing device used for rectal anastomoses in 62 patients undergoing high or low anterior resection or colectomy and ileorectal anastomosis was technically easy to use. The 38 high anastomoses were all shown to be intact by a Gastrografin, meglucomine diatrigoate, enema study 14 days after the operation. Of the 24 low anastomoses, six demonstrated small, 5 to 10 millimeters, dehiscences, two of the latter being evident also upon clinical examination. At least six of the low anastomoses were made at levels too low for hand suture from the abdomen. In three patients, moderate hemorrhage from the anastomotic site during the first two or three days complicated the situation; in all, it ceased spontaneously. In two patients, strictures developed, one of which rectified itself once the fecal stream was restored to the rectum on closing the transverse colostomy, the other was submitted to instrumental dilation, perhaps unnecessarily. The Model 249 circular suturing device provides colorectal anastomoses that are at least as secure as those done by hand suture and, sometimes, enables an anastomosis to be made at a lower level than would be possible by the conventional suture technique through the abdomen. Bleeding from the anastomotic site and subsequent stricture formation are rare complications of this technique.

Between October 1964 and June 1990, 243 patients with squamous cell carcinoma of the tonsillar region were treated with continuous-course radical radiotherapy at the University of Florida. All patients had a minimum 2-year follow-up. Patients were staged according to the AJCC system; stage IV was stratified into two subsets: favorable, IVA (T1-T3 or N2A-N3A); and unfavorable, IVB (T4 or N3B). The initial and ultimate local control rates (including surgical salvage) according to T stage were as follows: T1, 87% and 100%, T2, 79% and 92%; T3, 71% and 76%; and T4, 44% and 48%. Multivariate analysis demonstrated that anterior extension of the primary tumor (p = .0001) and T stage (p = .014) were the most significant parameters affecting local control after radiotherapy. For T4 lesions, twice-daily irradiation significantly improved local control (p = .04). The 5-year absolute and cause-specific survival rates as a function of modified AJCC stage were as follows: I, 37% and 100%; II, 55% and 90%; III, 55% and 85%; IVA, 35% and 60%; and IVB, 23% and 38%. The probability of a severe complication was 3% for the entire group of patients.

As a ultra‐precise measurement apparatus, the heterodyne laser interferometer has been widely used in various industrial fields. However the nonlinearity caused by the nonorthogonality and the ellipticity of two‐frequency input sources leads to imperfect displacement measurements. In this paper, the iterated adaptive fading Kalman filter algorithm is used to compensate the nonlinearity error. It can reduce the linearization error by repeated taylor series expansion around our new estimate and obtain high convergence rate. To demonstrate effectiveness of the proposed algorithm, the simulation results are presented with the improved measurement accuracy.

Most satellite systems for locating an aircraft use the measurement value of time difference of arrival (TDoA). However, when an emitter and receivers move simultaneously, the method with only TDoA measurement signal is not efficient for estimating the velocity of the emitter. To solve this problem, we use the FDoA signal which is the frequency difference by the Doppler shift. In this paper, we use two satellites which have a wireless receiver of embedded system to obtain signals of TDoA and FDoA. The precise positional estimation value is obtained using the AFKF algorithm which can resolve divergence problem of EKF algorithm in localization. Finally we demonstrate the effectiveness of the proposed algorithm through some simulation results.